DR. KEVIN MINSUNG KIM (NPI# 1831680750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831680750 |
| Entity Type | Individual |
| Full Name | DR. KEVIN MINSUNG KIM |
| Credential | DDS |
| Practice Address |
1717 Olympia Way Longview WA 98632-3929 |
| Practice Telephone | 3606361900 |
| Mailing Telephone | 3606361900 |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2020-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DE61034697 | WA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
DE61034697 | WA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DE61034697 | WA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Main St, Buffalo, NY 142092308 | 7162428200 | |
| 114 Squire Hall, Buffalo, NY 142148006 | 7168293717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518426535 | Kevin Kim | Student in an Organized Health Care Education/Training Program | 12361 E 17th Ave, Room 2004, Aurora, CO 80045 | 2019-03-19 |
| 1669993119 | Kevin Yongkwan Kim | Acupuncturist | 14464 Orange Grove Ave, Hacienda Heights, CA 91745-2557 | 2017-07-05 |
| 1396942058 | Kevin Yunsang Kim | Acupuncturist | 8033 Corporate Center Dr Ste 400, Charlotte, NC 28226-4549 | 2007-06-27 |
| 1346468618 | Kevin Kim | Dentist | 201 University Oaks Ste 770, Round Rock, TX 78665-2422 | 2007-04-23 |
| 1790848471 | Kevin Kim | Dentist | Kim, Jung, Stevens, Stevens, Dds Ps, 6001 100th St Sw, Lakewood, WA 98499-2733 | 2006-12-18 |
| 1104994557 | Kevin C Kim | Family Medicine | 3663 W 6th St # Suit302, Los Angeles, CA 90020-3049 | 2006-12-02 |
| 1851485056 | Kevin B. Kim | Internal Medicine | 2100 Webster St Ste 326, San Francisco, CA 94115-2378 | 2006-10-03 |
| 1942838370 | Kevin Kim | Student in an Organized Health Care Education/Training Program | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-03-31 |
| 1134626047 | Kevin Young Kim | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2018-04-07 |
| 1679081673 | Kevin Kim | Clinic/Center | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2018-01-12 |
| Street Address |
1717 OLYMPIA WAY |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891744371 | Nancy Ellen Goodwin | Acupuncturist | 1717 Olympia Way, Suite 104, Longview, WA 98632 | 2006-05-10 |
| 1063056711 | Peeyush Ranjan | Dentist | 1717 Olympia Way, Longview, WA 98632-3929 | 2019-11-05 |
| 1679953111 | Yazan Jaber | Dentist | 1717 Olympia Way, 3108, Longview, WA 98632 | 2015-05-29 |
| 1770806275 | Eid, Jaber, Jassar, Pllc | Clinic/Center | 1717 Olympia Way, Suite 108, Longview, WA 98632-3929 | 2010-03-11 |
| 1649446618 | Sun & Moon Acupuncture Clinic Inc | Acupuncturist | 1717 Olympia Way, Suite 104, Longview, WA 98632 | 2008-04-30 |
| 1528003944 | Hani Eid | Dentist | 1717 Olympia Way, Suite 101, Longview, WA 98632-3929 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023163524 | Justin Ray Horne | Dentist | 5 Doctor Cir, Longview, TX 75605-5050 | 2007-01-24 |
| 1740338003 | Joshua Richard Miner | Dentist | 5 Doctor Circle, Longview, TX 75605 | 2007-01-05 |
| 1225030455 | Mcgough & Mcgough, P.C. | Dentist | 2392 H G Mosley Pkwy, Longview, TX 75604-3661 | 2005-06-01 |
| 1063056711 | Peeyush Ranjan | Dentist | 1717 Olympia Way, Longview, WA 98632-3929 | 2019-11-05 |
| 1679953111 | Yazan Jaber | Dentist | 1717 Olympia Way, 3108, Longview, WA 98632 | 2015-05-29 |
| 1194129627 | Fadal Pediatric Dentistry, Pa | Dentist | 5 Doctor Cir, Longview, TX 75605-5050 | 2014-10-13 |
| 1528476348 | Horne & Miner Pediatric Dentristy, LLP | Dentist | 5 Doctor Cir, Longview, TX 75605-5050 | 2014-07-24 |
| 1215290697 | Culberson R Boren Dds Pa | Dentist | 705 E Marshall Ave, Medical Plaza IIi, Longview, TX 75601-5573 | 2012-06-20 |
| 1134380421 | Katherine Renee Mcgough | Dentist | 2392 H G Mosley Pkwy, Longview, TX 75604-3661 | 2008-06-19 |
| 1003031527 | Pediatric Dental Associates, LLP | Dentist | 5 Doctor Cir, Longview, TX 75605-5050 | 2007-04-17 |
| Find all providers in LONGVIEW | ||||
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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.