DR. HEE SOO KIM D.D.S
NPI 1609983535
Dentist - General Practice in Green Bay, WI

Q: What is Hee Soo Kim's NPI number?

The NPI number for Hee Soo Kim is 1609983535. It was assigned to this individual provider in the NPPES registry on August 24, 2006.

Q: What is Hee Soo Kim's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Hee Soo Kim 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.

Active since August 24, 2006PECOS Enrolled

430 MAIN ST, GREEN BAY, WI 54301(920) 431-0345 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Hee Soo Kim D.d.s NPPES

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

DR. HEE SOO KIM D.D.S (NPI 1609983535) is an individual general practice provider in Green Bay, Wisconsin, licensed in Wisconsin (5052-015) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609983535

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. HEE SOO KIMCredential: D.D.S

Location Address430 MAIN STGreen Bay, WI 54301-5115

Mailing Address400 E Wayfarer LnAppleton, WI 54913-6358 · (920) 954-8633

Phone(920) 431-0345

Sole ProprietorYes

Enumeration DateAugust 24, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1609983535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WI · 5052-015

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.

430 MAIN ST, Green Bay, WI 54301

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Other Identifiers 1

Medicaid33752700WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.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. Hee Soo 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 54301 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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 20

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

DR. WILLIAM ARTHUR BRENNAN D.D.S.

Dentist (Periodontics)