DR. MIN SOO KIM (NPI# 1528449873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528449873 |
| Entity Type | Individual |
| Full Name | DR. MIN SOO KIM |
| Credential | D.M.D |
| Practice Address |
2701 N Dirksen Pkwy Springfield IL 62702-1407 |
| Practice Telephone | 2178140407 |
| Mailing Telephone | 2178140407 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12012332A | IN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437490505 | Min Kim | Student in an Organized Health Care Education/Training Program | 1813 Spruce St, Apt 2f, Philadelphia, PA 19103-5806 | 2013-03-14 |
| 1376894436 | Min Kim | Pharmacist | 5005n Piedras St, 4008, El Paso, TX 79912 | 2012-09-28 |
| 1497028674 | Min Jung Kim | Chiropractor | 907 Aylesbury Dr, Allen, TX 75002-5745 | 2012-02-17 |
| 1629380936 | Min S Kim | Dentist | 7250 S Durango Dr Ste 110, Las Vegas, NV 89113-2221 | 2010-07-02 |
| 1669600896 | Min Kyu Kim | Dentist | 8035 S Rainbow Blvd # 102, Las Vegas, NV 89139 | 2009-06-25 |
| 1750566857 | Min Jeong Kim | Optometrist | 733 Manhattan Ave, Brooklyn, NY 11222-2944 | 2008-01-08 |
| 1912107194 | Min C. Kim | Dentist | 4270 Gorgas Circle, Fort Sam Houston, TX 78234-2639 | 2007-07-25 |
| 1861609240 | Min Kyung Kim | Acupuncturist | 1418 S Euclid St, Fullerton, CA 92832-3135 | 2007-05-17 |
| 1295833192 | Min Cheol Kim | Ophthalmology | 14155 North 83rd Avenue, Suite 1103, Peoria, AZ 85381 | 2006-09-21 |
| 1003914771 | Min Kyung Kim | Physical Medicine & Rehabilitation | 1200 S. York, #3160, Elmhurst, IL 60126 | 2006-09-20 |
| Street Address |
2701 N DIRKSEN PKWY |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190884 | Jorge Enrique Mosquera Castrillon | Dentist | 2701 N Dirksen Pkwy, Springfield, IL 62702-1407 | 2020-10-02 |
| 1720591837 | Ali Jarrar | Dentist | 2701 N Dirksen Pkwy, Springfield, IL 62702-1407 | 2017-11-10 |
| 1003328675 | Philco Dental Group LLC - Springfield | Dentist | 2701 N Dirksen Pkwy, Springfield, IL 62702-1407 | 2017-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434628 | Helina Mesfun | Dentist | 6512 Greenview Ln, Springfield, VA 22152-2918 | 2020-10-16 |
| 1336754456 | Springfield Dental Partners LLC | Dentist | 498 Harlow Rd Ste 2, Springfield, OR 97477-1339 | 2020-09-15 |
| 1699392308 | Mahmood Mahmood | Dentist | 6811 Meteor Pl Apt 204, Springfield, VA 22150-4518 | 2020-06-29 |
| 1124514807 | Myranda Nycole Wolff | Dentist | 2740 Prairie Crossing Dr, Springfield, IL 62711-7156 | 2018-07-06 |
| 1861987547 | Hovhannes Pahlevanyan | Dentist | 1795 Main St Ste 212, Springfield, MA 01103-1015 | 2018-06-26 |
| 1205329737 | Camille Renee Tague | Dentist | 2305 S Blackman Rd Ste 100, Springfield, MO 65809-2845 | 2018-06-09 |
| 1134611932 | George William Vincel | Dentist | 3259 E Sunshine St Ste Q, Springfield, MO 65804-2143 | 2018-06-06 |
| 1235636531 | Duff Family Dental, LLC | Dentist | 1722 S Glenstone Ave Ste O, Springfield, MO 65804-1513 | 2018-04-12 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1265948699 | Brighter Dental Care (springfield) | Dentist | 901 Mountain Avenue, Suite Sc-13, Springfield, NJ 07081 | 2017-12-21 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.