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

NPI Status: Active since July 17, 2006

Contact Information

1501 KINGS HWY
DEPARTMENT OF ORAL SURGERY
SHREVEPORT, LA
ZIP 71103
Phone: (318) 813-2625
Fax: (318) 813-2627

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  • Individual
  • Male
  • Years of Experience 29
  • Oral & Maxillofacial Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DONGSOO KIM

This page provides the complete NPI Profile along with additional information for Dongsoo Kim, a provider established in Shreveport, Louisiana with a medical specialization in Oral & Maxillofacial Surgery and more than 29 years of experience. The healthcare provider is registered in the NPI registry with number 1821016957 assigned on July 2006. The practitioner's primary taxonomy code is 204E00000X with license number 15055R (LA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1821016957
Provider Name
DR. DONGSOO DAVID KIM DMD, MD
Gender
Male
Entity Type
Individual
Location Address
1501 KINGS HWY DEPARTMENT OF ORAL SURGERY SHREVEPORT, LA 71103
Location Phone
(318) 813-2625
Location Fax
(318) 813-2627
Mailing Address
1501 KINGS HWY DEPARTMENT OF ORAL SURGERY SHREVEPORT, LA 71103
Mailing Phone
(318) 813-2625
Mailing Fax
(318) 813-2627
Medical School Name
OTHER
Graduation Year
1998
Is Sole Proprietor?
No
Enumeration Date
07-17-2006
Last Update Date
08-25-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Oral & Maxillofacial Surgery

Taxonomy Code
204E00000X
Type
Allopathic & Osteopathic Physicians
License No.
15055R
License State
LA
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223S0112XDental Providers

Dentist
Oral and Maxillofacial Surgery

5542 (LA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
  • Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
  • Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
  • Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3400 - PPO
  • Blue Dental Essential Certified- $1,000 Annual Benefit Maximum per Adult, 100%/50%/50% coinsurance, $75 deductible - PPO
  • Blue Dental Preferred Certified- $1,000 Annual Benefit Maximum per Adult, 100%/80%/50% coinsurance, $50 deductible - PPO
  • Blue Dental Value Certified- $500 Annual Benefit Maximum per Adult, 100%/60%/50% coinsurance, $0 deductible - PPO
  • Blue Dental Preferred Plus Certified- $1,500 Annual Benefit Maximum per Adult, 100%/80%/50% coinsurance, $50 deductible - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • Delta Dental PPO Basic Plan for Families - PPO
  • Delta Dental PPO Preferred Plan for Families - PPO
  • BlueDental Copayment Q - PPO
  • BlueDental Copayment QF - PPO
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (L) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (N) - POS
  • Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (S) - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (H) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (L) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (N) HSA Eligible - POS
  • Blue Connect Copay (PCP) 50/50 $7500 Standardized (S) HSA Eligible - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (L) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (N) - POS
  • Blue Connect Copay (PCP) 60/40 $6000 Standardized (S) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (H) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (L) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (N) - POS
  • Blue Connect Copay (PCP) 75/55 $2000 Standardized (S) - POS
  • Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
  • Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
  • Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
  • Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - Basic - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Lone Star - Smile Now - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1855421MEDICAID (05)LA 

Medicare Participation & PECOS Enrollment Status

Dongsoo Kim is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Dongsoo Kim is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8325052087

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20060201000758

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 10-19 minutes

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.

This service was performed 109 times for 70 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 65 times for 44 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 25 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 16 times for 16 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 15 times for 15 patients

X-ray of lower jaws, upper jaws and teeth

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.

This service was performed 60 times for 42 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Dongsoo Kim is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
OCHSNER LSU HEALTH SHREVEPORT1541 KINGS HIGHWAY
SHREVEPORT, LA 71103
(318) 675-5000Acute Care Hospitals
OCHSNER LSU HEALTH SHREVEPORT-ST MARY MEDICAL CENT911 MARGARET PLACE
SHREVEPORT, LA 71101
(318) 626-4300Acute Care Hospitals

Reviews for DR. DONGSOO DAVID KIM DMD, MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1821016957, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
2
Doubled → 4
Pos 4
1
Unchanged
Pos 5
0
Doubled → 0
Pos 6
1
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
9
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 6 → 12 → 3 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 4 + 1 + 0 + 1 + 1 + 2 + 9 + 1 + 0 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1821016957.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physician Assistant
1501 KINGS HWY, DEPT. OF NEUROSURGERY
SHREVEPORT, LA 71103
Surgery (Plastic and Reconstructive Surgery)
1501 KINGS HWY
SHREVEPORT, LA 71103
Anesthesiology
1501 KINGS HWY, DEPARTMENT OF ANESTHESIA
SHREVEPORT, LA 71103
Physician Assistant
1501 KINGS HWY
SHREVEPORT, LA 71103
Surgery
1501 KINGS HWY, LSUHSC-S DEPARTMENT OF SURGERY
SHREVEPORT, LA 71103
Counselor
1501 KINGS HWY, LSUHSC-S DEPARMTENT OF PSYCHIATRY
SHREVEPORT, LA 71103
Family Medicine
1501 KINGS HWY, DEPARTMENT OF FAMILY MEDICINE
SHREVEPORT, LA 71103
Psychiatry & Neurology (Neurology)
1501 KINGS HWY, DEPARTMENT OF NEUROLOGY
SHREVEPORT, LA 71103
Psychiatry & Neurology (Neurology)
1501 KINGS HWY, DEPARTMENT OF NEUROLOGY
SHREVEPORT, LA 71103
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1501 KINGS HWY, DEPARTMENT OF NEUROLOGY
SHREVEPORT, LA 71103
Emergency Medicine
1501 KINGS HWY, DEPARTMENT OF EMERGENCY MEDICINE
SHREVEPORT, LA 71103
Family Medicine
1501 KINGS HWY, DEPARTMENT OF FAMILY MEDICINE
SHREVEPORT, LA 71103
Psychiatry & Neurology (Psychiatry)
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY
SHREVEPORT, LA 71103
Pathology (Anatomic Pathology)
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY
SHREVEPORT, LA 71103
Pathology (Anatomic Pathology & Clinical Pathology)
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY
SHREVEPORT, LA 71103
Counselor (Professional)
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY
SHREVEPORT, LA 71103
Otolaryngology
1501 KINGS HWY, DEPARTMENT OF OTOLARYNGOLOGY
SHREVEPORT, LA 71103
Otolaryngology
1501 KINGS HWY, DEPARTMENT OF OTOLARYNGOLOGY
SHREVEPORT, LA 71103
Otolaryngology
1501 KINGS HWY, DEPARTMENT OF OTOLARYNGOLOGY
SHREVEPORT, LA 71103
Orthopaedic Surgery
1501 KINGS HWY, DEPARTMENT OF ORTHOPAEDICS
SHREVEPORT, LA 71103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821016957, enumerated as an "individual" on July 17, 2006.

The provider is located at 1501 KINGS HWY DEPARTMENT OF ORAL SURGERY SHREVEPORT, LA 71103 and the phone number is (318) 813-2625.

Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.

Dongsoo Kim is affiliated with: OCHSNER LSU HEALTH SHREVEPORT and OCHSNER LSU HEALTH SHREVEPORT-ST MARY MEDICAL CENT.