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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. SHIWOO KIM D.M.D
NPI 1255873345
Dentist - Oral and Maxillofacial Surgery in Shoreline, WA

Active since November 07, 2016Opted out of Medicare · through Nov 11, 2026
15823 WESTMINSTER WAY N, SHORELINE, WA 98133(213) 590-5686 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 9, 2026, Nov 7, 2016 (2 updates tracked since 2016).

About Dr. Shiwoo Kim D.m.d NPPES

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

DR. SHIWOO KIM D.M.D (NPI 1255873345) is an individual oral and maxillofacial surgery provider in Shoreline, Washington, licensed in Washington (DE61424421) and active in the NPI registry since November 2016. He has opted out of Medicare through November 11, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1255873345
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. SHIWOO KIMCredential: D.M.D
Location Address15823 WESTMINSTER WAY NShoreline, WA 98133-5928
Mailing Address15823 Westminster WayN Shoreline, WA 98113-4761 · (213) 590-5686
Phone(213) 590-5686
Sole ProprietorYes
Enumeration DateNovember 7, 2016
Last NPPES UpdateJuly 9, 20262 updates tracked since enumeration
NPPES CertifiedJuly 9, 2026
✔ NPI 1255873345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in WA · DE61424421
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License DDS100351 (CA)
15823 WESTMINSTER WAY N, Shoreline, WA 98133
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Shiwoo Kim D.m.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 11, 2024 through November 11, 2026.

Opt-Out Effective DateNovember 11, 2024
Opt-Out In Effect ThroughNovember 11, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98133 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
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
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 2

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

JAWNT ORAL SURGERY
Clinic/Center (Oral and Maxillofacial Surgery)
15823 WESTMINSTER WAY N
SHORELINE, WA 98133
King County (206) 848-5788
GREEN LAKE ORAL & FACIAL SURGERY
Dentist
15823 WESTMINSTER WAY N
SHORELINE, WA 98133
King County (206) 848-5788

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 Shiwoo Kim's NPI number?

The NPI number for Shiwoo Kim is 1255873345. It was assigned to this individual provider in the NPPES registry on November 7, 2016.

Where is Shiwoo Kim located?

Shiwoo Kim practices at 15823 Westminster Way N, Shoreline, WA 98133. The listed phone number is (213) 590-5686.

What is Shiwoo Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Shiwoo Kim enrolled in Medicare?

No. Shiwoo Kim has opted out of Medicare through November 11, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Shiwoo Kim accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Shiwoo 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 Shiwoo Kim was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.