DR. SEONG JU KIM (NPI# 1609906270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609906270 |
| Entity Type | Individual |
| Full Name | DR. SEONG JU KIM |
| Credential | DDS |
| Practice Address |
424 W Fullerton Pkwy Chicago IL 60614-2812 |
| Practice Telephone | 7734040101 |
| Mailing Telephone | 7734040101 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063841864 | Seong Hee Kim | Registered Nurse | 4200 De Haven Dr, Chantilly, VA 20151-2810 | 2013-11-02 |
| 1528129350 | Seong Ja Kim | Pediatrics | 438 56th Street, Brooklyn, NY 11220-3409 | 2006-12-13 |
| 1316987605 | Seong Il Kim | Internal Medicine | 1245 Wilshire Blvd Ste 303, Los Angeles, CA 90017 | 2006-06-07 |
| 1457351702 | Seong Cheol Kim | Preventive Medicine | 68934 Vinewood Ave, Sturgis, MI 49091-8899 | 2005-07-28 |
| 1023569621 | Seong Kim | Physician Assistant | 7650 E Parham Rd, Suite 220, Henrico, VA 23294-4373 | 2016-10-18 |
| 1669850491 | Seong Eun Kim | Occupational Therapist | 324 Roxbury Rd, Rockford, IL 61107-5090 | 2015-05-13 |
| 1205187119 | Seong Kim | Technician, Health Information | 1153 Oak St, San Francisco, CA 94117-2216 | 2012-10-02 |
| 1962753178 | Seong Sook Kim | Pharmacist | 51 Mdg, Unit 2060, Apo, AP 96278 | 2012-09-27 |
| 1730487075 | Seong G Kim | Pharmacist | 842 S 5th Ave, Denton, MD 21629-1398 | 2011-03-10 |
| 1710296660 | Seong Kim | Dentist | 307 W Main St, Battle Ground, WA 98604-4411 | 2010-09-27 |
| Street Address |
424 W FULLERTON PKWY |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-2812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619968880 | Linh Thuy Tran | Dentist | 424 W Fullerton Pkwy, Chicago, IL 60614-2812 | 2005-11-04 |
| 1548436959 | Lincoln Park Dental Care Ltd | Dentist | 424 W Fullerton Pkwy, Chicago, IL 60614-2812 | 2008-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1679181895 | Robert J Chacon | Dentist | 15 S Throop St Apt 206, Chicago, IL 60607-2522 | 2020-07-14 |
| 1629693304 | Priyanka Sikka | Dentist | 300 W Grand Ave Apt 303, Chicago, IL 60654-7855 | 2020-06-09 |
| 1164045456 | Yong Chang Dds PC. | Dentist | 3531 N Western Ave Unit B, Chicago, IL 60618-6025 | 2020-05-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1831749944 | Kenwood Dental Group | Dentist | 1335 E 87th St Ste A, Chicago, IL 60619-7036 | 2019-09-19 |
| 1508412875 | Kamal Paresh Patel | Dentist | 1040 W Randolph St, Chicago, IL 60607-2215 | 2019-08-13 |
| 1003469636 | Ahmed Mansour | Dentist | 2122 N Milwaukee Ave Ste 1, Chicago, IL 60647-4251 | 2019-07-23 |
| 1568024925 | John Michael Burnheimer II | Dentist | 11 S Green St Unit 1106, Chicago, IL 60607-1031 | 2019-07-05 |
| 1497317515 | Prasanth Dommaraju | Dentist | 3924 S Archer Ave, Chicago, IL 60632-1116 | 2019-06-29 |
| Find all providers in CHICAGO | ||||
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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.