DR. MARY GRACE KIM D.D.S.
NPI 1053729467
Dentist - General Practice in Niles, IL

Active since July 29, 2014PECOS Enrolled
8321 W GOLF RD, NILES, IL 60714(847) 720-3504(847) 692-5271 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 2, 2022, Jan 31, 2022, Dec 20, 2018 (3 updates tracked since 2018).

About Dr. Mary Grace Kim D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARY GRACE KIM D.D.S. (NPI 1053729467) is an individual general practice provider in Niles, Illinois, licensed in Illinois (019029922) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053729467
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MARY GRACE KIMCredential: D.D.S.
Location Address8321 W GOLF RDNiles, IL 60714-1113
Mailing Address2424 W. PetersonChicago, IL 60659 · (773) 761-0300 · Fax (773) 761-0009
Fax(847) 692-5271
Sole ProprietorNo
Enumeration DateJuly 29, 2014
Last NPPES UpdateDecember 2, 20223 updates tracked since enumeration
NPPES CertifiedDecember 2, 2022
NPI 1053729467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in IL · 019029922
Definition

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.

8321 W GOLF RD, Niles, IL 60714

Other Identifiers 1

Medicaid019029922IL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Mary Grace Kim D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60714 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
8321 W GOLF RD
NILES, IL 60714
Internal Medicine
8321 W GOLF RD
NILES, IL 60714
Clinic/Center (Federally Qualified Health Center (FQHC))
8321 W GOLF RD
NILES, IL 60714

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Kim's NPI number?

The NPI number for Mary Kim is 1053729467. It was assigned to this individual provider in the NPPES registry on July 29, 2014.

Where is Mary Kim located?

Mary Kim practices at 8321 W Golf Rd, Niles, IL 60714. The listed phone number is (847) 720-3504.

What is Mary Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mary Kim enrolled in Medicare?

Yes. Mary Kim is registered in the Medicare PECOS enrollment system.

What insurance does Mary Kim accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana and 2 other insurers list Mary Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Kim was last updated on December 2, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.