Maria Wong Kim, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

14246 Issued in MO

Practice address

6309 Hazelwest CT
Hazelwood, MO 63042-1739

Phone

(314) 731-1688

Fax

(314) 731-7938

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Maria Wong Professional name

Medicare fee-for-service enrollment

Enrolled in MO

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

Practice roles

Interoperability endpoints

• Direct secure messaging: maria.wong.p1@direct.affiniahealthcare.nextgenshare.com

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.

• Little Smiles of Hazelwood, LLC

  • Pediatric Dentistry
  • Hazelwood, MO
  • NPI 1922765866
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992886592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 HAZELWEST CT",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421739",
            "telephone_number": "314-731-1688",
            "fax_number": "314-731-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 HAZELWEST CT",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421739",
            "telephone_number": "314-731-1688",
            "fax_number": "314-731-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARIA",
        "middle_name": "WONG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "14246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "WONG",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shawn Khosla
• Robert Joseph Killion, MS,LAT,ATC
• Jeong Nam Kim-Judd, MD
• Andrew M. Kim, D.M.D.
• Jaclyn Jeonghoon Kim, MD
• Kindred Connections Nemt Services, LLC
• Donna Renae King, MA, LPC
• Shawn A King
• Kingdom Hearts in-Home LLC
• Kathleen A Kleinschmidt, MS-CCC-SLP

• Dentist in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.