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DR. KEVIN K SHIM D.D.S.
NPI 1386784437
Dentist - General Practice in Gresham, OR

Active since February 07, 2007PECOS Enrolled
1201 SE 223RD AVE, SUITE 260, GRESHAM, OR 97030(503) 667-1184 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kevin K Shim D.d.s. NPPES

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

DR. KEVIN K SHIM D.D.S. (NPI 1386784437) is an individual general practice provider in Gresham, Oregon, licensed in Oregon (D8645) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386784437
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KEVIN K SHIMCredential: D.D.S.
Location Address1201 SE 223RD AVE, SUITE 260Gresham, OR 97030-2574
Mailing Address13180 Se Snowfire DrHappy Valley, OR 97236-8022
Phone(503) 667-1184
Sole ProprietorYes
Enumeration DateFebruary 7, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1386784437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OR · D8645
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.
1201 SE 223RD AVE, Gresham, OR 97030
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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. Kevin K Shim 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 97030 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
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 6

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

DR. DOUGLAS LEE PARK DDS
Dentist (Pediatric Dentistry)
1201 SE 223RD AVE, SUITE 240
GRESHAM, OR 97030
Multnomah County (503) 666-9800
DR. DANIEL J RIES D.M.D.
Dentist (General Practice)
1201 SE 223RD AVE, SUITE 140
GRESHAM, OR 97030
Multnomah County (503) 665-8116
CASCADE VISION CENTER INC.
Optometrist
1201 SE 223RD AVE, SUITE 160
GRESHAM, OR 97030
Multnomah County (503) 492-2020
DR. PERRY A. STEVENSON DDS, MS, PC
Dentist (Orthodontics and Dentofacial Orthopedics)
1201 SE 223RD AVE, SUITE 220
GRESHAM, OR 97030
Multnomah County (503) 661-8719
DANIEL J RIES, DMD, PC
Clinic/Center (Dental)
1201 SE 223RD AVE, SUITE 140
GRESHAM, OR 97030
Multnomah County (503) 665-8116
HUMBLE RICHMOND & RUSSELL ORAL & MAXILLOFACIAL SURGERY, LLC
Dentist (Oral and Maxillofacial Surgery)
1201 SE 223RD AVE, SUITE 180
GRESHAM, OR 97030
Multnomah County (503) 667-1431

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 Kevin Shim's NPI number?

The NPI number for Kevin Shim is 1386784437. It was assigned to this individual provider in the NPPES registry on February 7, 2007.

Where is Kevin Shim located?

Kevin Shim practices at 1201 SE 223rd Ave Suite 260, Gresham, OR 97030. The listed phone number is (503) 667-1184.

What is Kevin Shim's specialty?

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

Is Kevin Shim enrolled in Medicare?

Yes. Kevin Shim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Shim was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.