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Active NPI 1518752435 Individual Practitioner Male Practitioner

Dr. Tae Ho Kong , DDS

Dentist • Sullivan, MO

Professional Overview & Biography Verified Profile Summary

Dr. Tae Ho Kong, DDS is a registered healthcare professional specializing in Dentist in Sullivan, MO. Practice services are available at 101 PROGRESS PKWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

101 Progress Pkwy

Sullivan, MO 630802359

Telephone 8448538937
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Sullivan, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.6 Yrs
Regional Practice Density
7 Specialists

Practicing in Sullivan, MO (1740 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: 2025-04-11
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MO 2024047593

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License IL 019034531

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.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Charlene Atkins

Counselor - Professional

NPI 1003075482
NPI 1003270851

Master of Arts, LADCS, CPCI, Licensed Professional Counselor

Lindsey Rahe

Counselor - Professional

NPI 1003452186
Kayle Streb , LCSW

Social Worker - Clinical

NPI 1003503467

Licensed Clinical Social Worker

Lindsay Ingram , LPC

Counselor - Professional

NPI 1003527144

Licensed Professional Counselor

Dr. Nikesha Walters , DMD

Dentist - General Practice

NPI 1003545294

Doctor of Dental Medicine

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active April 11, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location April 11, 2025

Registered at 101 PROGRESS PKWY, SULLIVAN, MO 630802359 (Tel: 8448538937)

📍
Updated Business Mailing Address April 11, 2025

Registered at 1800 COMMUNITY, CLINTON, MO 647358804

👤
Provider Name / Credentials Updated April 11, 2025

Recorded as TAE HO KONG, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2025

Dentist (License #019034531 in IL)

🟢
Initial NPI Registration & Enumeration April 11, 2025

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: 1518752435
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 11, 2025
Last Update: April 11, 2025
Sole Proprietor: No

Mailing Address

1800 Community

Clinton, MO 647358804

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.