David Yongtae Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4937 Issued in AL

Practice address

506 1St Ave S.E
Cullman, AL 35055

Phone

(256) 739-3337

Fax

(256) 739-3165

NPI assigned

Oct 2, 2006

Last updated

Jul 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Today's Family Dentistry, P.C.

  dba Cullman Dental

  • Dentist
  • Cullman, AL
  • NPI 1790962074
  Authorized official Same address or phone
• Today's Family Dentistry, P.C.

  • Dentist
  • Cullman, AL
  • NPI 1992981443
  NPD (past) Authorized official
• Today's Family Dentistry, P.C.

  dba Blount Dental Center

  • General Practice Dentistry
  • Cleveland, AL
  • NPI 1336455815
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1710070776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 910",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35055",
            "telephone_number": "256-739-3337",
            "fax_number": "256-739-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 1ST AVE S.E",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35055",
            "telephone_number": "256-739-3337",
            "fax_number": "256-739-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "YONGTAE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009920665",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley A Ketchum, D.O.
• Kevin Johnson MD PC
• Kevin W. Neal, O.D., P.C.
• Ajmal Muhammad Khan, MD
• Stephanie Kilgo, BS
• Cynthia L Kimbrough, CRNP
• Darcel King, LICSW
• Suzanne N King, DIETICIAN
• Madison Ware Kiser
• KKP Holdings LLC (Specialty Pharmacy)

• General Practice Dentistry in Cullman, AL
• Providers in Cullman, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.