Myung Joon Kim, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

3549 Issued in ME

Practice address

10 Market Square
Suite 3
South Paris, ME 04281

Phone

(207) 743-8701

Fax

(207) 743-2787

NPI assigned

Apr 19, 2007

Last updated

Jul 8, 2007By 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

Enrolled in ME

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

State licenses

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.

• Crossway Family Dental PA

  dba Western Maine Dentistry

  • General Practice Dentistry
  • Norway, ME
  • NPI 1043673957
  NPD (past) Authorized official
• Crossway Family Dental PA

  • General Practice Dentistry
  • South Paris, ME
  • NPI 1700098241
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821215039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MARKET SQUARE",
            "address_2": "SUITE 3",
            "city": "SOUTH PARIS",
            "state": "ME",
            "postal_code": "04281",
            "telephone_number": "207-743-8701",
            "fax_number": "207-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MARKET SQUARE",
            "address_2": "SUITE 3",
            "city": "SOUTH PARIS",
            "state": "ME",
            "postal_code": "04281",
            "telephone_number": "207-743-8701",
            "fax_number": "207-743-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MYUNG",
        "middle_name": "JOON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "3549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tobie Feigenbaum, LCSW
• Taylor Morgan Hjelmeland, MA CCC-SLP
• Aaron Im, D.M.D.
• Karla L Diffin, Inc
• Taylor Marie Kemp, LCSW LADC CCS
• Sarah Renee Lane, CADC
• Maine Veterans' Home
• Maine Veterans' Homes
• Market Square Health Care Center, LLC
• Kaci Lyn McPherson, APRN, WHNP

• Dentist in South Paris, ME
• Providers in South Paris, ME by specialty
• Dentist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.