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DR. SHANNA KYUNGMI KIM DDS
NPI 1710282272
Dentist - Orofacial Pain in Sparks, NV

Active since January 14, 2011Opted out of Medicare · through Jun 12, 2027
4840 VISTA BLVD STE 108, SPARKS, NV 89436(775) 362-9374 Get Directions Write a Review

NPPES record last updated: November 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 3, 2021, Oct 19, 2021, Sep 24, 2021 and 4 more (7 updates tracked since 2019).

About Dr. Shanna Kyungmi Kim Dds NPPES

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

DR. SHANNA KYUNGMI KIM DDS (NPI 1710282272) is an individual orofacial pain provider in Sparks, Nevada, licensed in Nevada (7344) and active in the NPI registry since January 2011. She has opted out of Medicare through June 12, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1710282272
Entity TypeIndividualFemale
Primary Taxonomy1223X2210X
Provider Legal NameDR. SHANNA KYUNGMI KIMCredential: DDS
Location Address4840 VISTA BLVD STE 108Sparks, NV 89436-2850
Mailing AddressPo Box 17128Reno, NV 89511-3101
Phone(775) 362-9374
Sole ProprietorYes
Enumeration DateJanuary 14, 2011
Last NPPES UpdateNovember 28, 20247 updates tracked since enumeration
NPPES CertifiedNovember 28, 2024
✔ NPI 1710282272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Orofacial PainDental Providers
Taxonomy Code1223X2210X
License✔ Licensed in NV · 7344
Definition
A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.
4840 VISTA BLVD STE 108, Sparks, NV 89436
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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, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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. Shanna Kyungmi Kim Dds 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 June 12, 2025 through June 12, 2027.

Opt-Out Effective DateJune 12, 2025
Opt-Out In Effect ThroughJune 12, 2027Opt-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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of body plane 76100
An X-ray of a body plane is a non-invasive imaging test that helps visualize the inside of your body. It uses a small amount of radiation to produce images of structures within your body, such as bones and organs. This procedure aids in diagnosing, monitoring, and treating various medical conditions.
52 services26 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
37 services25 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services25 patients
X-ray of face bones, 1-2 views 70140
An X-ray of face bones, with 1-2 views, is a simple, quick imaging test. It uses a small amount of radiation to produce images of the bones in your face. This test can help detect fractures, infections, or other abnormalities. It's painless and non-invasive.
26 services26 patients
X-ray of paranasal sinus, minimum of 3 views 70220
An X-ray of the paranasal sinus involves taking multiple images of the spaces around your nose that produce mucus, aiding in clearing and moistening your nasal passages. This helps detect issues like infections, blockages, or abnormalities.
26 services26 patients
X-ray of lower jaws, upper jaws and teeth 70355
An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.
26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89436 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
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
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 3

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

DR. SCOTT GLENN SUTTER D.D.S.
Dentist (Endodontics)
4840 VISTA BLVD STE 108
SPARKS, NV 89436
Washoe County (775) 236-4950
CAMERON CODY GREEN BCBA
Behavior Analyst
4840 VISTA BLVD STE 108
SPARKS, NV 89436
Washoe County (775) 354-1380
SHANNA K. KIM DDS, PLLC
Dentist (Orofacial Pain)
4840 VISTA BLVD STE 108
SPARKS, NV 89436
Washoe County (775) 241-8489

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 Shanna Kim's NPI number?

The NPI number for Shanna Kim is 1710282272. It was assigned to this individual provider in the NPPES registry on January 14, 2011.

Where is Shanna Kim located?

Shanna Kim practices at 4840 Vista Blvd Ste 108, Sparks, NV 89436. The listed phone number is (775) 362-9374.

What is Shanna Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orofacial Pain, with taxonomy code 1223X2210X.

Is Shanna Kim enrolled in Medicare?

No. Shanna Kim has opted out of Medicare through June 12, 2027. 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 Shanna Kim accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Shanna 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 Shanna Kim was last updated on November 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.