Jong Wook Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

043564-1 Issued in NY

Practice address

3636 Prince St Ste 304
Flushing, NY 11354

Phone

(718) 358-3636

Fax

(718) 353-3600

NPI assigned

May 19, 2008

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 names 1

• Dr. John Kim Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Joeun Dental P.C.

  • General Practice Dentistry
  • Flushing, NY
  • NPI 1861280653
  NPD Authorized official

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1720245772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 PRINCE ST STE 304",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544031",
            "telephone_number": "718-358-3636",
            "fax_number": "718-353-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 PRINCE ST STE 304",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-358-3636",
            "fax_number": "718-353-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONG",
        "middle_name": "WOOK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043564-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jisook Kim
• John J. Kim, MD
• John Kwang Kim, L. AC.
• Jong Hoon Kim, FNP
• Jong Sin Kim
• Jong-Min Jonathon Kim, PHARMD
• Jongho Kim, DMD LAC PHD
• Joon Lae Kim, LIC.A
• Joonhyuk Kim, MD
• Joshua Seokju Kim

• General Practice Dentistry in Flushing, NY
• Providers in Flushing, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.