Eugene Jung Kim, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

9251 Issued in AZ

Practice address

8575 E Princess Dr
Suite 217
Scottsdale, AZ 85255-5483

Phone

(480) 342-8200

Fax

(480) 342-8008

NPI assigned

Oct 11, 2005

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

Other identifiers 1

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 Sep 10, 2015 through Sep 10, 2027

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Pinnacle Peak Oral Surgery, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Scottsdale, AZ
  • NPI 1063893295
  NPD (past) Authorized official

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1851389225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 E PRINCESS DR",
            "address_2": "SUITE 217",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555483",
            "telephone_number": "480-342-8200",
            "fax_number": "480-342-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 E PRINCESS DR",
            "address_2": "SUITE 217",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555483",
            "telephone_number": "480-342-8200",
            "fax_number": "480-342-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUGENE",
        "middle_name": "JUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "9251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49585711",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Brian Kilby
• Caroline Ashley Kilian, M.D.
• Michael Edward Killian, MD
• Dennis L Kilpatrick, M.D.
• William R Kilpatrick
• Hanna Kim
• James Youngsoo Kim, MD
• Jennifer H Kim, M.D.
• Joshua Kim, D.O.
• Lauren Kim, DMD

• Oral and Maxillofacial Surgery (Dentist) in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.