JOHN MINKYU KIM DDS
NPI 1699039792
Oral & Maxillofacial Surgery in Ann Arbor, MI

Active since July 03, 2012PECOS Enrolled
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109(734) 936-4000 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, May 21, 2019, Dec 27, 2018 (3 updates tracked since 2018).

About John Minkyu Kim Dds NPPES

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

JOHN MINKYU KIM DDS (NPI 1699039792) is an individual oral & maxillofacial surgery provider in Ann Arbor, Michigan, licensed in Michigan (2901601571) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1699039792
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameJOHN MINKYU KIMCredential: DDS
Location Address1500 E MEDICAL CENTER DRAnn Arbor, MI 48109-5000
Mailing Address3621 S State StAnn Arbor, MI 48108-1633 · (734) 647-5299
Sole ProprietorNo
Enumeration DateJuly 3, 2012
Last NPPES UpdateAugust 2, 20233 updates tracked since enumeration
NPPES CertifiedAugust 2, 2023
NPI 1699039792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License Licensed in MI · 2901601571
Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Also ListedDentistTaxonomy 122300000X · License DT 2474 (HI)
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License DT-2474 (HI)
Also ListedPharmacistTaxonomy 183500000X · License PH 2612 (HI)
1500 E MEDICAL CENTER DR, Ann Arbor, MI 48109

Secondary Practice Locations 2

Location 12441 21st StFort Campbell, KY 42223-5582 · Phone (270) 798-8751
Location 2618TH DENTAL CO. USAG HUMPHREYS, CARIUS DENTAL CLINIC, UNIT # 15660, BLDG # P3020APO, AP 96271-5660 · Phone (808) 295-8453

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)

John Minkyu Kim Dds 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.

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.

Pathology (Forensic Pathology)
1500 E MEDICAL CENTER DR, 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
ANN ARBOR, MI 48109
Internal Medicine (Gastroenterology)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Pathology (Cytopathology)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Pediatrics
1500 E MEDICAL CENTER DR, 12TH FLOOR C.S. MOTT CHILDREN'S HOSPITAL ROOM 525
ANN ARBOR, MI 48109
Pediatrics (Pediatric Infectious Diseases)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Physician Assistant
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Nurse Anesthetist, Certified Registered
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Family Medicine (Hospice and Palliative Medicine)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

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 John Kim's NPI number?

The NPI number for John Kim is 1699039792. It was assigned to this individual provider in the NPPES registry on July 3, 2012.

Where is John Kim located?

John Kim practices at 1500 E Medical Center Dr, Ann Arbor, MI 48109. The listed phone number is (734) 936-4000.

What is John Kim's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is John Kim enrolled in Medicare?

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

What insurance does John Kim accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list John 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 John Kim was last updated on August 2, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.