DR. CHANG MIN RICHARD YIM (NPI# 1417398405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417398405 |
| Entity Type | Individual |
| Full Name | DR. CHANG MIN RICHARD YIM |
| Credential | DMD |
| Practice Address |
1401 Mercantile Ln Ste 102 Largo MD 20774-4306 |
| Mailing Address |
7001 Arlington Rd Bethesda MD 20814-5405 |
| Practice Telephone | 3013410041 |
| Mailing Telephone | 2158405782 |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2020-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 16977 | MD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 618th Dental Company (as), Usa Dentac - K, Unit 15652, Apo Ap 96205 - 5652, Apo, AP 962055652 | 01182279172600 | |
| 1357 Good Hope Rd Se, Washington, DC 200206909 | 2026100600 | |
| 8901 Rockville Pike, Bethesda, MD 20889 | 3012954340 | |
| 1401 Mercantile Ln Ste 102, Largo, MD 207744306 | 3013410041 |
| Street Address |
1401 MERCANTILE LN STE 102 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-4306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346427820 | Robert K Mensah | Dentist | 1401 Mercantile Ln Ste 102, Largo, MD 20774 | 2008-01-27 |
| 1548813876 | Rkm Orthodontics LLC | Clinic/Center | 1401 Mercantile Ln Ste 102, Largo, MD 20774-4306 | 2019-07-16 |
| 1568026458 | Caroline Larosiliere Dds and Associates | Dentist | 1401 Mercantile Ln Ste 102, Largo, MD 20774-4306 | 2019-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679902407 | Antoine G Johnson Dds LLC | Oral & Maxillofacial Surgery | 3450 Ellicott Center Dr, 104, Ellicott City, MD 21043-4172 | 2013-11-02 |
| 1366889479 | Eric J Wu | Oral & Maxillofacial Surgery | 5900 Waterloo Rd Ste 220, Columbia, MD 21045-2638 | 2013-05-30 |
| 1043656655 | Scott Seung Young Kim | Oral & Maxillofacial Surgery | 6201 Greenbelt Rd Ste M1, College Park, MD 20740-2358 | 2013-05-22 |
| 1760558787 | Michael E Suden | Oral & Maxillofacial Surgery | 12166 Old Big Bend, Ste 101, Kirkwood, MD 63122 | 2006-11-28 |
| 1811060734 | Behrens & Kishter PC | Oral & Maxillofacial Surgery | 11404 Old Georgetown Road, Suite 104, Rockville, MD 20852 | 2006-11-16 |
| 1639141609 | Peter M Tan | Oral & Maxillofacial Surgery | 68 Thomas Johnson Dr, Suite A, Frederick, MD 21702 | 2006-02-03 |
| 1467446344 | John F Caccamese Jr. | Oral & Maxillofacial Surgery | 650 W. Baltimore St., Suite 1401, Baltimore, MD 21201 | 2005-09-07 |
| 1992798524 | Leonard Spector | Oral & Maxillofacial Surgery | 10 Warren Rd, Ste 330, Cockeysville, MD 21030-2506 | 2005-08-30 |
| 1023001641 | Spector & Krupps Dds | Oral & Maxillofacial Surgery | 1220b E Joppa Rd, Ste 314, Towson, MD 21286-5813 | 2005-08-30 |
| 1811998966 | Barry Ronald Berman | Oral & Maxillofacial Surgery | 110 Painters Mill Rd, Suite 8, Owings Mills, MD 21117-4920 | 2005-08-10 |
| Find all providers with the same taxonomy | ||||
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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.