Raymond Jihoon Kim, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901021567 Issued in MI

Practice address

35300 Woodward Ave Apt 307
Birmingham, MI 48009-0955

Phone

(231) 740-3014

NPI assigned

Oct 1, 2015

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

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 Oct 19, 2015 through Oct 19, 2027

Medicare enrollment (NPD)

Enrolled

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.

• Brightside Dental

  • General Practice Dentistry
  • Sterling Heights, MI
  • NPI 1154538569
  NPD (past)

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1962872028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35300 WOODWARD AVE APT 307",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480090955",
            "telephone_number": "231-740-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35300 WOODWARD AVE APT 307",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480090955",
            "telephone_number": "231-740-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RAYMOND",
        "middle_name": "JIHOON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venus Lenice Kelso
• David Scott Kesler, D.C.
• Kevin Garfield DPM PC
• Louie Khouri, DDS
• Velanda Kilano, PHARM D
• David Alan Kirsch, D.C.
• Joel Howard Kirsch, D.C.
• Nadine Klait, RN, BSN, MSN, FNP-BC
• Jan Klein
• Michael Ira Klein, MD

• All providers in Birmingham, MI
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.