Dongsu Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28875 Issued in FL

Practice address

1799 N Williamson Blvd Apt 7210
Daytona Beach, FL 32117-5309

Phone

(804) 937-9680

NPI assigned

Apr 3, 2023

Last updated

Jan 8, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1730884560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E 25TH ST APT 5F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102501",
            "telephone_number": "804-937-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1799 N WILLIAMSON BLVD APT 7210",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175309",
            "telephone_number": "804-937-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONGSU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahzad Khurshid, M.D.
• Chester Kikla Jr., ARNP
• Omolola L Kilanibala, APRN
• Lamesha Doushette Killins
• Arlie Elaine Kilman
• Joo Yon Kim, MD
• Megan Elizabeth Kim
• Myunghwa Kim, ARNP
• Nathan Sung in Kim, MD
• Carolyn Ann King, MS, CCC/SLP

• General Practice Dentistry in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.