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

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: July 19, 2026.

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
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

Other Identifiers 1

Medicaid33752700WI

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. 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.

Dentist
430 MAIN ST
GREEN BAY, WI 54301
Dentist (Pediatric Dentistry)
430 MAIN ST
GREEN BAY, WI 54301
Dentist (Periodontics)
430 MAIN ST
GREEN BAY, WI 54301
Dentist (Prosthodontics)
430 MAIN ST
GREEN BAY, WI 54301
Dentist (Oral and Maxillofacial Surgery)
430 MAIN ST
GREEN BAY, WI 54301
Dentist
430 MAIN ST
GREEN BAY, WI 54301
Dentist (General Practice)
430 MAIN ST
GREEN BAY, WI 54301
Dentist (General Practice)
430 MAIN ST
GREEN BAY, WI 54301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609983535, enumerated as an "individual" on August 24, 2006.

The provider is located at 430 MAIN ST GREEN BAY, WI 54301 and the phone number is (920) 431-0345.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.