DR. YOUNG TAE SHIM (NPI# 1790011609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790011609 |
| Entity Type | Individual |
| Full Name | DR. YOUNG TAE SHIM |
| Credential | DMD |
| Practice Address |
2925 Premiere Pkwy Ste 175b Duluth GA 30097-5258 |
| Mailing Address |
2953 Springbluff Ln Buford GA 30519-4195 |
| Practice Telephone | 4049109060 |
| Mailing Telephone | 4045120760 |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2010-06-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN13999 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669793782 | Young R Shim | Psychologist | 5410 Transportation Blvd Ste 4, Garfield Heights, OH 44125-5300 | 2010-06-14 |
| 1316236052 | Young H Shim | Emergency Medicine | 801 7th Ave, Fort Worth, TX 76104-2733 | 2011-04-04 |
| Street Address |
2925 PREMIERE PKWY STE 175B |
| City | DULUTH |
| State | GA |
| Zip Code | 30097-5258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1649808619 | Kirsty Amber Ramirez | Behavior Technician | 218 Premiere Pkwy #500, Duluth, GA 30097 | 2020-03-27 |
| 1386277820 | Cristina Madalina Niculas | Pharmacist | Kroger Pharmacy 476, 6555 Sugarloaf Parkway, Duluth, GA 30097 | 2020-02-12 |
| 1619514924 | Opesdei Health Solutions | Home Health Aide | 6615 Abbotts Bridge Road, 6615 Abbotts Bridge Road Unit 1111, Johns Creek, GA 30097 | 2019-12-05 |
| 1700422979 | Ria Alexander | Nurse Practitioner | 6300 Hospital Parkway Ste 300, Johns Creek, GA 30097 | 2019-11-22 |
| 1043867765 | Mosesal Zakia White | Nurse Practitioner | 10680 Medlock Bridge Rd #102, Johns Creek, GA 30097 | 2019-08-19 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1306330303 | Denise Jackson | Prosthetist | 11720 Medlock Bridge Rd Ste 155, Johns Creek, GA 30097 | 2018-06-21 |
| 1407363328 | Berkeley Van Dyke | Physical Therapist | 6335 Hospital Pkwy Ste 316, Johns Creek, GA 30097 | 2017-12-30 |
| Find all providers in zip 30097 | ||||
| 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 |
|---|---|---|---|---|
| 1144835570 | Affordable Dentures & Implants of Georgia II, LLC | Dentist | 3675 Satellite Blvd Ste 700, Duluth, GA 30096-2309 | 2020-09-11 |
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1477074466 | Kelly Ann Pohlman | Dentist | 3700 Crestwood Pkwy Nw Ste 180, Duluth, GA 30096-5583 | 2017-06-29 |
| 1487191649 | Sage Dental Group of Georgia, LLC | Dentist | 11160 Medlock Bridge Rd, Suite 120, Duluth, GA 30097-2590 | 2017-01-26 |
| 1730538661 | Gianna Paola Koker | Dentist | 4310 Menard Dr Ste 300, Duluth, MN 55811-1564 | 2016-06-10 |
| 1932560034 | Jasmine Ahn | Dentist | 7063 Belltoll Ct, Duluth, GA 30097-2507 | 2016-03-16 |
| 1518340009 | Go Eun Kim | Dentist | 2476 Pleasant Hill Rd Ste 201, Duluth, GA 30096-4300 | 2015-07-02 |
| 1912315730 | Jonathan Hu Chang | Dentist | 1630 Pleasant Hill Rd Ste 200, Duluth, GA 30096-5828 | 2014-07-24 |
| 1861836553 | Joanna I Bodea | Dentist | 5805 State Bridge Rd Ste L, Duluth, GA 30097-6427 | 2013-04-24 |
| 1154669406 | Thomas E Geoghegan | Dentist | 2785 Buford Hwy, Bldg. B, Suite 101, Duluth, GA 30096-2800 | 2013-01-22 |
| Find all providers in DULUTH | ||||
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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.