Woosol Kim, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

33132 Issued in TX

Practice address

1067 Twining Dr
Barksdale Afb, LA 71110-2486

Phone

(318) 456-6718

NPI assigned

Aug 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1871979427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 TWINING DR",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102486",
            "telephone_number": "609-754-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 TWINING DR",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102486",
            "telephone_number": "318-456-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WOOSOL",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-05",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414964",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie M. Johnson, PA-C
• Orien Dalton Joseph, PHARM.D.
• Candace Key, DDS
• Rula Khalaf
• Barnabas Kyunghwan Kim, DMIN, MDIV, BCC
• Terence Jay Kinyon, DDS
• Lindsey Marie Larimer, BSN, RN
• Janell Larkin, PHARMD.
• Srikanth Choudary Lavu, DO
• Cynthia Williams Lecara

• Dentist in Barksdale Afb, LA
• Providers in Barksdale Afb, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.