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DR. DONGSOO DAVID KIM DMD, MD
NPI 1821016957
Oral & Maxillofacial Surgery in Shreveport, LA

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
1501 KINGS HWY, DEPARTMENT OF ORAL SURGERY, SHREVEPORT, LA 71103(318) 813-2625(318) 813-2627 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Dongsoo David Kim Dmd, Md NPPES

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

DR. DONGSOO DAVID KIM DMD, MD (NPI 1821016957) is an individual oral & maxillofacial surgery provider in Shreveport, Louisiana, licensed in Louisiana (15055R) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Ochsner Lsu Health Shreveport, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1821016957
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. DONGSOO DAVID KIMCredential: DMD, MD
Location Address1501 KINGS HWY, DEPARTMENT OF ORAL SURGERYShreveport, LA 71103-4228
Mailing Address1501 Kings Hwy, Department Of Oral SurgeryShreveport, LA 71103-4228 · (318) 813-2625 · Fax (318) 813-2627
Phone(318) 813-2625
Fax(318) 813-2627
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJuly 17, 2006
Last NPPES UpdateAugust 25, 2021
NPPES CertifiedAugust 25, 2021
✔ NPI 1821016957 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in LA · 15055R
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 ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 5542 (LA)
1501 KINGS HWY, Shreveport, LA 71103
Open in Google Maps ↗

Other Identifiers 1

Medicaid1855421LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dongsoo David Kim Dmd, Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325052087
PECOS Enrollment IDI20060201000758
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Dongsoo Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lsu Health Sciences Center Shreveport Faculty Group Practice
0.1 mi
Family Medicine
1541 KINGS HWY
Shreveport, LA 71103
  • Reassigned Medicare billing, Louisiana enrollment
  • 1,167 clinicians in this Medicare group
NPI 1013374222 (318) 626-0000
Rapides Healthcare System, LLC
111 mi
Urgent Care
105 N 3RD ST
Alexandria, LA 71301
  • Reassigned Medicare billing, Louisiana enrollment
  • 45 clinicians in this Medicare group
NPI 1477970168 (318) 769-8160

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.
61 services42 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
43 services37 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.
39 services30 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.
30 services29 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
27 services21 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.
21 services20 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ochsner Lsu Health Shreveport

Acute Care Hospitals · Shreveport, LA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190098
Location1541 Kings HighwayShreveport, LA 71103 · Caddo County
Emergency services Birthing friendly

Ochsner Lsu Health Shreveport-St Mary Medical Cent

Acute Care Hospitals · Shreveport, LA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190317
Location911 Margaret PlaceShreveport, LA 71101 · Caddo County
Birthing friendly

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.

HS LOUISIANA, LLC
General Practice
1501 KINGS HWY, SUITE 5-303
SHREVEPORT, LA 71103
Caddo Parish (904) 834-2679
MUNIRA DAWITH MD
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY, PSYCHIATRY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-6619
SEFI AHMED JAWADI
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0505
LUKE MUIZNIEKS
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-1574
KRISTIN BEMBENICK
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-5300
CHRISTIAN SCOTT BAKER MD
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-5053
BRYCE MILLER DO
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0434
NEERAJ PAVAN REDDY TELUGU
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0434

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 Dongsoo Kim's NPI number?

The NPI number for Dongsoo Kim is 1821016957. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Dongsoo Kim located?

Dongsoo Kim practices at 1501 Kings Hwy Department Of Oral Surgery, Shreveport, LA 71103. The listed phone number is (318) 813-2625.

What is Dongsoo Kim's specialty?

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

Is Dongsoo Kim enrolled in Medicare?

Yes. Dongsoo Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Dongsoo Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dongsoo Kim reassigns Medicare benefits to 2 organizations: Lsu Health Sciences Center Shreveport Faculty Group Practice (Shreveport, LA) and Rapides Healthcare System, LLC (Alexandria, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dongsoo Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dongsoo Kim accept?

Health plans from Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental and 11 other insurers list Dongsoo 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.

Is Dongsoo Kim affiliated with any hospitals?

According to CMS data, Dongsoo Kim is affiliated with Ochsner Lsu Health Shreveport and Ochsner Lsu Health Shreveport-St Mary Medical Cent.

When was this NPI record last updated?

The NPPES record for Dongsoo Kim was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.