Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1720531403 Individual Practitioner Male Practitioner

Dr. John D Kim , DMD

Dentist • Tyler, TX

Professional Overview & Biography Verified Profile Summary

Dr. John Kim, DMD is a registered healthcare professional specializing in Dentist in Tyler, TX. Practice services are available at 110 E 9TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

110 E 9th St

Tyler, TX 757014227

Telephone 9039914991
Associated Practice Facility / Clinic
🏢 Tyler Family Circle Of Care Facility NPI 1144575820

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Tyler, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
47 Specialists

Practicing in Tyler, TX (6851 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: 2023-04-08
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 38650

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 319.020174

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.

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location April 08, 2023

Registered at 110 E 9TH ST, TYLER, TX 757014227 (Tel: 9039914991)

📍
Updated Business Mailing Address April 08, 2023

Registered at 523 S FANNIN AVE, TYLER, TX 757028204 (Tel: 9035359041)

📍
Updated Practice Location June 16, 2022

Registered at 1431 S INTERSTATE 35 STE 105, GEORGETOWN, TX 786265427 (Tel: 5127588634)

📍
Updated Business Mailing Address June 16, 2022

Registered at 1431 S INTERSTATE 35 STE 105, GEORGETOWN, TX 786265427 (Tel: 7073310447)

NPI Profile Active July 28, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location July 28, 2016

Registered at 5137 W CHICAGO AVE, CHICAGO, IL 606512904 (Tel: 7733784694)

📍
Updated Business Mailing Address July 28, 2016

Registered at 839 N SACRAMENTO BLVD, #2D, CHICAGO, IL 606224366 (Tel: 7073310447)

👤
Provider Name / Credentials Updated July 28, 2016

Recorded as JOHN KIM, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2016

Dentist (License #319.020174 in IL)

🟢
Initial NPI Registration & Enumeration July 28, 2016

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: 1720531403
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2016
Last Update: April 08, 2023
Sole Proprietor: No

Mailing Address

523 S Fannin Ave

Tyler, TX 757028204

Phone: 9035359041

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.