Yung Kyun Kim, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

010754 Issued in CT

Practice address

University of Connecticut Health Ctr
263 Farmington Avenue
Farmington, CT 06030-0001

Phone

(860) 679-4070

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 6, 2015 through Nov 6, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1831394352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6470 CLOVERDALE BLVD",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642721",
            "telephone_number": "917-375-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF CONNECTICUT HEALTH CTR",
            "address_2": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YUNG KYUN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053348-1",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "010754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "010754",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "053348-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Agnes Kim, M.D.
• Hyun a Kim, D.M.D.
• Jin Woo Kim, M.D.
• Stella Kim
• Wanjin Kim
• Mary G Kinahan, APRN
• Alyson Frances King, PA-C
• Erika King, MD
• Heather Marie King, M.D.
• Kali King, MD

• Periodontics in Farmington, CT
• Providers in Farmington, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.