John D Kim, DMD in Tyler, TX - Medicare Dentist Provider

John D Kim, DMD is a medicare enrolled "Dentist" provider in Tyler, Texas. His current practice location is 110 E 9th St, Tyler, Texas. You can reach out to his office (for appointments etc.) via phone at (903) 991-4991.

John D Kim is licensed to practice in Texas (license number 38650) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720531403.

Contact Information

	John D Kim, DMD
	110 E 9th St, Tyler, TX 75701-4227
	(903) 991-4991
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	John D Kim
Gender	Male
Speciality	Dentist
Location	110 E 9th St, Tyler, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720531403
Provider Enumeration Date: 07/28/2016
Last Update Date: 04/08/2023

Medicare PECOS Information:

PECOS PAC ID: 7012380165
Enrollment ID: I20230310001117

Medical Identifiers

Medical identifiers for John D Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720531403	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	319.020174 (Illinois)	Secondary
122300000X	Dentist	38650 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. John D Kim allows following entities to bill medicare on his behalf.

Entity Name	Tyler Family Circle Of Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144575820 PECOS PAC ID: 4587812888 Enrollment ID: O20120911000666

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John D Kim is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
John D Kim, DMD 523 S Fannin Ave, Tyler, TX 75702-8204 Ph: (903) 535-9041	John D Kim, DMD 110 E 9th St, Tyler, TX 75701-4227 Ph: (903) 991-4991

Reviews and Comments

Dentist in Tyler, TX

Dr. Larry Mike Bloodsworth, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1001 Magnolia Drive, Tyler, TX 75701 Phone: 903-595-2707
Dr. Luke Jacob Dlabal Iii, DDS Dentist Medicare: Medicare Enrolled Practice Location: 5605 Old Bullard Rd, Tyler, TX 75703 Phone: 903-747-3919
Dr. Marcus William Worden, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2336 Aberdeen Dr, Tyler, TX 75703 Phone: 903-581-1646
Larry Wayne Murph, DDS Dentist Medicare: Medicare Enrolled Practice Location: 3201 Paluxy Dr, Tyler, TX 75701 Phone: 903-593-5161 Fax: 903-593-8359
Dr. David Frank Nichols, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 4700 Kinsey Drive, Tyler, TX 75703 Phone: 903-561-7604 Fax: 903-561-7388
Jung Won Park, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 212 Old Grande Blvd Ste B224, Tyler, TX 75703 Phone: 903-509-0505
Dr. Donna Gordon Lindsey, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5540 Old Jacksonville Hwy, Tyler, TX 75703 Phone: 903-597-2121 Fax: 903-581-7776

John D Kim, DMD - Medicare Dentist in Tyler, TX