Richard Yongyup Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1001209-15 Issued in WI

Practice address

1838 S 15TH Street
Milwaukee, WI 53204

Phone

(414) 455-8805

NPI assigned

Apr 10, 2007

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• D2 Dental of Wisconsin, S.C.

  • General Practice Dentistry
  • Milwaukee, WI
  • NPI 1245742733
  NPD
• Pro Dental Wi 1 PC

  dba Destiny Dental of Milwaukee

  • Dentist
  • Milwaukee, WI
  • NPI 1013744523
  NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1740403559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1050 MAKAIKAI ST APT 8K",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967894318",
            "telephone_number": "213-550-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 S 15TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53204",
            "telephone_number": "414-455-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RICHARD",
        "middle_name": "YONGYUP",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-2535",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41631",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031953",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001209-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kuylhee Kim, M.D.
• Michael Kim
• Michael Kim, M.D.
• Mijo Kim
• Rebecca Yoonjung Kim, MD
• Rosa K. Kim, M.D.
• Soo Kim, MD
• Vivian Teresa Kim, MD
• Theresa Louise Kimball, CAA
• Amy N Kimber, NP

• Dentist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.