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DR. SONGHYON KIM DDS
NPI 1912076738
Dentist in Parker, AZ

Active since November 07, 2006PECOS Enrolled
12033 AGENCY RD, PARKER, AZ 85344(928) 669-2137(928) 669-3131 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 15, 2025, Jan 14, 2023, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Dr. Songhyon Kim Dds NPPES

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

DR. SONGHYON KIM DDS (NPI 1912076738) is an individual dentist in Parker, Arizona, licensed in Utah (265201-9923) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1912076738
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. SONGHYON KIMCredential: DDS
Location Address12033 AGENCY RDParker, AZ 85344-7718
Mailing AddressPo Box 95461Cleveland, OH 44101-0033 · (928) 669-2137 · Fax (928) 669-3131
Phone(928) 669-2137
Fax(928) 669-3131
Sole ProprietorNo
Enumeration DateNovember 7, 2006
Last NPPES UpdateAugust 15, 20254 updates tracked since enumeration
NPPES CertifiedAugust 15, 2025
✔ NPI 1912076738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in UT · 265201-9923✔ Licensed in OH · 30.025304✔ Licensed in OR · D10160✔ Licensed in UT · 265201
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
12033 AGENCY RD, Parker, AZ 85344
Open in Google Maps ↗

Secondary Practice Locations 3

Location 14044 Morse RdColumbus, OH 43230-1448 · Phone (614) 473-0400 · Fax (913) 752-9116
Location 22961 W Maple Loop Dr Ste 110Lehi, UT 84043-5717 · Phone (801) 766-4042
Location 3992 Country Club Rd Ste 102Eugene, OR 97401-6023 · Phone (855) 433-6825

Other Identifiers 1

Medicaid1912076738UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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 (PECOS)

Dr. Songhyon 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.

Medicare Billing Reassignments

3

Medicare enrollment records show Songhyon Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dhhs Ihs Phoenix Area
Same address
Critical Access
12033 AGENCY RD
Parker, AZ 85344
  • Reassigned Medicare billing, Texas enrollment
  • 208 clinicians in this Medicare group
NPI 1851678585 (928) 669-2137
Dhhs Ihs Phoenix Area
108 mi
Clinic/Center
943 HUALAPAI WAY
Peach Springs, AZ 86434
  • Reassigned Medicare billing, Texas enrollment
  • 210 clinicians in this Medicare group
NPI 1265719934 (928) 769-2900
Irene Benn Medical Center
175 mi
Clinic/Center
10 LINCOLN ST
Moapa, NV 89025
  • Reassigned Medicare billing, Texas enrollment
  • 143 clinicians in this Medicare group
NPI 1841535317 (775) 784-5327

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85344 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

DONNA M MITCHELL RN
Registered Nurse
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-2137
GLORIA A HARPER CLA(ASCP)
Specialist/Technologist, Pathology
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-2137
DR. ANGEL VIDAL ARAFILES MD
General Practice
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-2137
MS. LESLIE DIANE TINCHER RN
Registered Nurse
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-2137
BART TRUJILLO RT(R)
Radiologic Technologist (Radiography)
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-3380
DR. DAWN AILEEN KELLY O.D.
Optometrist
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-3289
MS. NESIE DOMINGO DACULA DENTAL HYGIENIST
Dental Hygienist
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-3154
MS. VALERIE LAVANGE SCOTT R.N.
Registered Nurse (Community Health)
12033 AGENCY RD
PARKER, AZ 85344
LA Paz County (928) 669-2137

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 Songhyon Kim's NPI number?

The NPI number for Songhyon Kim is 1912076738. It was assigned to this individual provider in the NPPES registry on November 7, 2006.

Where is Songhyon Kim located?

Songhyon Kim practices at 12033 Agency Rd, Parker, AZ 85344. The listed phone number is (928) 669-2137.

What is Songhyon Kim's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Songhyon Kim enrolled in Medicare?

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

Which organizations bill Medicare for Songhyon Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Songhyon Kim reassigns Medicare benefits to 3 organizations: Dhhs Ihs Phoenix Area (Parker, AZ), Dhhs Ihs Phoenix Area (Peach Springs, AZ) and Irene Benn Medical Center (Moapa, NV). 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 Songhyon Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Songhyon Kim accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, HRI Dental & Vision and Humana and 3 other insurers list Songhyon 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 Songhyon Kim was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.