Organization Active NPI

Hodiah DMD LLC

  • Dentist
  • Clarksville, MD
National Provider Identifier
1861057044
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HODIAH DMD LLC
Practice address
6100 Daylong LN Ste 204
Clarksville, MD 21029-1655
Phone
(667) 200-5912
Fax
(443) 546-3330
NPI assigned
May 3, 2019
Last updated
May 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Authorized official

Name
Dr. Hyoung Keun Kim, DMD
Title
Doctor
Phone
(667) 200-5912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

6100 Daylong LN Ste 204
Clarksville, MD 21029-1655

Mailing address

6100 Daylong LN Ste 204
Clarksville, MD 21029-1655
Phone (667) 200-5912

National Provider Directory

National Provider Directory

Locations

6100 Daylong Ln
Ste 204
Clarksville, MD 21029
Phone (410) 531-9400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1861057044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 DAYLONG LN STE 204",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291655",
            "telephone_number": "667-200-5912",
            "fax_number": "443-546-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 DAYLONG LN STE 204",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291655",
            "telephone_number": "667-200-5912",
            "fax_number": "443-546-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODIAH DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HYOUNG KEUN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "667-200-5912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.