Active NPI
Hyunsoo Kim, D.D.S.
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1720798853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11942
- Practice address
- 3057 W Cermak Rd
Chicago, IL 60623-3548 - Phone
- (312) 274-4550
- NPI assigned
- Nov 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11942 | CT | Primary |
Addresses
Primary practice location
3057 W Cermak Rd
Chicago, IL 60623-3548
Mailing address
855 W Madison St Apt 717
Chicago, IL 60607-3138
Phone (929) 340-9390
Other practice location 1
181, Dogok-ro, Gang nam gu
Kim's dental clinic
Seoul, Please select region, state or province 06288
KR
Phone (822) 556-3204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1720798853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 W MADISON ST APT 717",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606073138",
"telephone_number": "929-340-9390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3057 W CERMAK RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606233548",
"telephone_number": "312-274-4550"
}
],
"practiceLocations": [
{
"address_1": "181, Dogok-ro, Gang nam gu",
"address_2": "Kim's dental clinic",
"address_purpose": "LOCATION",
"city": "Seoul",
"state": "Please select region, state or province",
"postal_code": "06288",
"country_code": "KR",
"telephone_number": "822-556-3204",
"country_name": "Korea, Republic of",
"address_type": "FGN"
}
],
"basic": {
"last_name": "KIM",
"first_name": "HYUNSOO",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-30",
"last_updated": "2022-11-30",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "11942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.