DR. GRACE KYUNG KIM (NPI# 1972750370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972750370 |
| Entity Type | Individual |
| Full Name | DR. GRACE KYUNG KIM |
| Credential | D.O. |
| Practice Address |
2615 Box Canyon Dr Las Vegas NV 89128-0450 |
| Practice Telephone | 7029989001 |
| Practice Fax Number | 7029984999 |
| Mailing Telephone | 7029989001 |
| Mailing Fax Number | 7029984999 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2016-09-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
DO1788 | NV | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407417611 | Grace Kim | Acupuncturist | 414 N Coast Highway 101, Encinitas, CA 92024-2529 | 2019-06-27 |
| 1417415662 | Grace Kim | Dietitian, Registered | 2120 Evergreen Dr, San Bruno, CA 94066-1828 | 2019-03-06 |
| 1467971283 | Grace Y Kim | Student in an Organized Health Care Education/Training Program | Lacdmh Hucla 1000 W. Carson Street, Torrance, CA 90502 | 2017-09-13 |
| 1023405305 | Grace Eunheh Kim | Dentist | 7112 Ed Bluestein Blvd Ste 130, Austin, TX 78723-2924 | 2015-04-23 |
| 1679991897 | Grace Kim | Pediatrics | 925 E Southlake Blvd, Suite 100, Southlake, TX 76092 | 2014-04-03 |
| 1437572153 | Grace Kim | Occupational Therapist | 1607 W Redondo Beach Blvd, Gardena, CA 90247-3241 | 2014-01-31 |
| 1912335001 | Grace Jiin Kim | Acupuncturist | 61 Campbell Ave, Woodcliff Lake, NJ 07677-8061 | 2013-10-29 |
| 1255766119 | Grace Kim | Registered Nurse | 19416 37th Ave, Flushing, NY 11358-4003 | 2013-09-11 |
| 1366787103 | Grace G Kim | Physical Therapist | 375 Dover Chester Rd, Randolph, NJ 07869-3910 | 2012-12-05 |
| 1255684189 | Grace Donghwa Kim | Acupuncturist | 61 E 75th St Fl 2, New York, NY 10021-2739 | 2012-10-16 |
| Street Address |
2615 BOX CANYON DR |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89128-0450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518993260 | Carol Lynn Tanko | Nurse Anesthetist, Certified Registered | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2006-06-24 |
| 1871964676 | Kasie Palmer | Physician Assistant | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2015-10-19 |
| 1558618710 | Marvin D Spann Md Pllc | Plastic Surgery | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2012-08-07 |
| 1407044399 | Marvin Douglas Spann | Plastic Surgery | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2007-10-04 |
| 1700964780 | Candace Thornton Spann | Dermatology | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2006-11-01 |
| 1770667081 | Cynthia Rydzewski Fitzgerald | Nurse Anesthetist, Certified Registered | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
| 1619589462 | Eldercare Services Lv, LLC | Technician | 8430 W. Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-08-21 |
| 1508477308 | Amneris Lizet Duran-brocato | Technician | 1150 North Buffalo Dr. Apt 2120, Las Vegas, NV 89128 | 2020-08-14 |
| 1366082612 | Ar Home Health Management LLC | Home Health | 7465 W Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-01-14 |
| 1114563731 | Leslie A Pasternack | Acupuncturist | Integrated Acupuncture of Southern Nevada, 7250 Peak Dr #106, Las Vegas, NV 89128 | 2019-11-19 |
| 1154977940 | Devora Susana Leon-lopez | Chore Provider | 7320 Smoke Ranch Rd. Ste. H, Las Vegas, NV 89128 | 2019-08-16 |
| 1659924884 | Blanca Estela Garnica-mendez | Chore Provider | 7320 Smoke Ranch Rd. Suite H, Suite H, Las Vegas, NV 89128 | 2019-07-17 |
| 1467913160 | Sherwin Necunazar Azad | Student in an Organized Health Care Education/Training Program | Mountainview Hospital Gme, 3100 N. Tenaya Way, Las Vegas, NV 89128 | 2019-03-26 |
| 1962963801 | Michael Richard Korczynski | Student in an Organized Health Care Education/Training Program | 3100 North Tenaya Way, Las Vegas, NV 89128 | 2019-03-25 |
| 1013477041 | Yuanlong Zhao | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way Graduate Medical Education, Las Vegas, NV 89128 | 2019-03-25 |
| Find all providers in zip 89128 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323362 | Fife Dermatology PC | Dermatology | 2110 E Flamingo Rd # 213, Las Vegas, NV 89119-5190 | 2019-06-05 |
| 1407992217 | Daniel Taheri Md PC | Dermatology | 5731 S Fort Apache Rd Ste 130, Las Vegas, NV 89148-5666 | 2007-01-29 |
| 1083636369 | James Del Rosso | Dermatology | 9097 W Post Rd Ste 100, Las Vegas, NV 89148-2417 | 2006-07-24 |
| 1174923221 | F. Victor Rueckl Dermatology, Pllc | Dermatology | 8861 W Sahara Ave Ste 290, Las Vegas, NV 89117-4808 | 2014-08-26 |
| 1740516699 | Fife Dermatology, P.C. | Dermatology | 6460 Medical Center St, Ste 350, Las Vegas, NV 89148-2406 | 2009-10-28 |
| 1649505496 | Mac Lee Machan | Dermatology | 6460 Medical Center St Ste 350, Las Vegas, NV 89148-2423 | 2009-10-13 |
| 1730101023 | Douglas Thomas | Dermatology | 9097 W Post Rd, Suite 100, Las Vegas, NV 89148-2411 | 2006-07-24 |
| 1134147853 | Lucius Blanchard | Dermatology | 4488 S Pecos Rd, Las Vegas, NV 89121-5030 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821569138 | Fife Dermatology, P.C. | Dermatology | 1736 W. Horizon Ridge Parkway, Henderson, NV 89012 | 2018-12-13 |
| 1073820536 | Lauren Michelle Lee | Dermatology | 276 Kingsbury Grade Ste 101, Stateline, NV 89449-9804 | 2010-09-04 |
| 1063595924 | Martin E. Salm, M.d., Ltd. | Dermatology | 276 Kingsbury Grade, Suite 101, Stateline, NV 89449-5910 | 2006-10-23 |
| 1003905001 | Skin Cancer and Dermatology Institute | Dermatology | 3950 Gs Richards Blvd, Carson City, NV 89703-8457 | 2006-10-11 |
| 1740633015 | Mountain West Derm - Blackhart Pllc | Dermatology | 3950 Gs Richards Blvd, Carson City, NV 89703-8457 | 2016-07-21 |
| 1780856559 | Martin E. Salm, M.d., Ltd | Dermatology | 276 Kingsbury Grade, Suite 101, Stateline, NV 89449-5910 | 2008-04-01 |
| 1780852368 | Clemmensen, Adams, & Tack Psc | Dermatology | 1100 S Carson St, Carson City, NV 89701-5232 | 2008-02-15 |
| 1841214632 | Ruth Elizabeth Adams | Dermatology | 1100 S Carson St, Carson Dematology, Carson City, NV 89701-5232 | 2006-07-26 |
| 1053314708 | Dan E Rowe | Dermatology | 640 W Moana Ln, Reno, NV 89509-4857 | 2005-05-24 |
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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.