Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053729467 Individual Practitioner Female Practitioner

Dr. Mary Grace Kim , DDS

Dentist - General Practice • Niles, IL

Professional Overview & Biography Verified Profile Summary

Dr. Mary Kim, DDS is a registered healthcare professional specializing in Dentist - General Practice in Niles, IL. Practice services are available at 8321 W GOLF RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8321 W Golf Rd

Niles, IL 607141113

Telephone 8477203504
Fax 8476925271
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Niles, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
33 Specialists

Practicing in Niles, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-12-02
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019029922

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
019029922 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1245201326

Doctor of Medicine (M.D.)

Dr. Sheri Schreiber , MD

Obstetrics & Gynecology

NPI 1710972187

Doctor of Medicine (M.D.)

NPI 1730493891

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location December 20, 2018

Registered at 8321 W GOLF RD, NILES, IL 607141113 (Tel: 8477203504)

📍
Updated Business Mailing Address December 20, 2018

Registered at 2424 W. PETERSON, CHICAGO, IL 60659 (Tel: 7737610300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 20, 2018

Dentist (License #019029922 in IL)

NPI Profile Active July 29, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location July 29, 2014

Registered at 505 CLAREMONT PKWY, BRONX, NY 104578304 (Tel: 7182993600)

📍
Updated Business Mailing Address July 29, 2014

Registered at 158 ALLEN ST, APT 4, NEW YORK, NY 100022119 (Tel: 7735109251)

👤
Provider Name / Credentials Updated July 29, 2014

Recorded as MARY KIM, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 29, 2014

Dentist (License #057370 in NY)

🟢
Initial NPI Registration & Enumeration July 29, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053729467
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 29, 2014
Last Update: December 02, 2022
Sole Proprietor: No

Mailing Address

2424 W. Peterson

Chicago, IL 60659

Phone: 7737610300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.