DR. JUNG-WAN MARTIN KIM (NPI# 1568624815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568624815 |
| Entity Type | Individual |
| Full Name | DR. JUNG-WAN MARTIN KIM |
| Credential | BSC, DMD |
| Practice Address |
515 Delaware Street Se 7-360 Moos Health Science Tower Minneapolis MN 55455 |
| Practice Telephone | 6126256177 |
| Practice Fax Number | 6126262652 |
| Mailing Telephone | 6126256177 |
| Mailing Fax Number | 6126262652 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D12492 | MN | Dental Providers |
| Street Address |
515 DELAWARE STREET SE 7-360 MOOS HEALTH SCIENCE TOWER |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699745323 | Paul Christopher Tompach | Dentist | 515 Delaware Street Se, 7-174 Moos Health Sciences Tower, Minneapolis, MN 55455 | 2006-01-25 |
| 1922623834 | Mohammad Mujtaba Methani | Dentist | 515 Delaware Street Se, Moos Health Science Tower, Minneapolis, MN 55455 | 2020-06-16 |
| 1437790466 | Arpit Nirkhiwale | Dentist | 515 Delaware Street Se, 9-470 Moos Tower, Minneapolis, MN 55455 | 2019-10-01 |
| 1851884712 | Alessandro Pedercini | Dentist | 515 Delaware Street Se, 7-368 Moos Health Science Tower, Minneapolis, MN 55455 | 2018-06-14 |
| 1215388061 | Aarathi Rao | Dentist | 515 Delaware Street Se, 7-174 Moos Health Science Tower, Minneapolis, MN 55455-0329 | 2016-06-23 |
| 1881042802 | Mitchell Andrew Loeb | Dentist | 515 Delaware Street Se, 9-176 Moos Health Science, Minneapolis, MN 55455 | 2016-05-31 |
| 1356774954 | Akanksha Gupta | Dentist | 515 Delaware Street Se, 6-440 Moos Health Science Tower, Minneapolis, MN 55455-0356 | 2013-08-19 |
| 1639418452 | Lauren Thomaier | Obstetrics & Gynecology | 515 Delaware Street Se, 12th Floor Moos, Division of Gynecologic Oncology, Minneapolis, MN 55455 | 2013-02-14 |
| 1609172972 | Satbir S Grover | Student in an Organized Health Care Education/Training Program | 515 Delaware Street Se, 15-136 Moos Tower, Minneapolis, MN 55455 | 2011-02-04 |
| 1093047771 | Robert Simon Jones | Dentist | 515 Delaware Street Se, 6-150 Moos Health Sciences, Minneapolis, MN 55455 | 2010-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| 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 |
|---|---|---|---|---|
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1871150417 | Muktar Farah | Dentist | 115 Broadway St Ne, Minneapolis, MN 55413-1805 | 2019-05-20 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1861975245 | Sara Tejani | Dentist | 2232 Hennepin Ave. S., Minneapolis, MN 55405 | 2018-09-11 |
| 1811483795 | Minnesota Durable Medical Equipment LLC | Dentist | 15600 36th Ave N Ste 270, Minneapolis, MN 55446-3372 | 2018-07-03 |
| 1871010165 | Mayank Shrivastava | Dentist | 515 Delaware St Se # 6-320, Minneapolis, MN 55455-0357 | 2017-08-28 |
| 1659808079 | Christopher David Carvalho | Dentist | 515 Delaware St Se Fl 7, Minneapolis, MN 55455-0357 | 2017-05-16 |
| 1821449133 | Yannie Chea | Dentist | 616 Washington Ave Se Apt 213, Minneapolis, MN 55414-2998 | 2016-06-28 |
| 1245688969 | Daniel Jabs | Dentist | 7-368 Moos Tower, 515 Delaware St Se, Minneapolis, MN 55455 | 2016-06-03 |
| 1780039263 | Ursula Mcguckin | Dentist | 825 Nicollet Avenue #1025, Minneapolis, MN 55402 | 2016-05-03 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
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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.