Tae Ho Kong, DDS in Sullivan, MO - Medicare Dentist Provider

Tae Ho Kong, DDS is a medicare enrolled "Dentist" provider in Sullivan, Missouri. His current practice location is 101 Progress Pkwy, Sullivan, Missouri. You can reach out to his office (for appointments etc.) via phone at (844) 853-8937.

Tae Ho Kong is licensed to practice in Missouri (license number 2024047593) 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 1518752435.

Contact Information

	Tae Ho Kong, DDS
	101 Progress Pkwy, Sullivan, MO 63080-2359
	(844) 853-8937
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Tae Ho Kong
Gender	Male
Speciality	Dentist
Location	101 Progress Pkwy, Sullivan, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1518752435
Provider Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025

Medicare PECOS Information:

PECOS PAC ID: 2264957141
Enrollment ID: I20250423002604

Medical Identifiers

Medical identifiers for Tae Ho Kong such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518752435	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	019034531 (Illinois)	Secondary
122300000X	Dentist	2024047593 (Missouri)	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. Tae Ho Kong allows following entities to bill medicare on his behalf.

Entity Name	Compass Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285619494 PECOS PAC ID: 1951206754 Enrollment ID: O20040408000955

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. Tae Ho Kong 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
Tae Ho Kong, DDS 1800 Community, Clinton, MO 64735-8804 Ph: () -	Tae Ho Kong, DDS 101 Progress Pkwy, Sullivan, MO 63080-2359 Ph: (844) 853-8937

Reviews and Comments

Dentist in Sullivan, MO

Dr. James Ray Cuneio, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 20 Hughes Ford Rd, Sullivan, MO 63080 Phone: 573-468-3512
Dr. Raysham Hayat, DDS Dentist Medicare: Medicare Enrolled Practice Location: 101 Progress Pkwy, Sullivan, MO 63080 Phone: 844-853-8937
Dr. Christopher Allen Parks, DDS Dentist Medicare: Medicare Enrolled Practice Location: 400 Cumberland Way, Suite A, Sullivan, MO 63080 Phone: 573-468-7556 Fax: 573-468-7530
Dr. Mark Alan Scantlan, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 675 Dunsford Dr, Sullivan, MO 63080 Phone: 573-468-2774 Fax: 573-468-2008
Dr. John Hamblin, DMD Dentist Medicare: Medicare Enrolled Practice Location: 413 Walmart Dr, Sullivan, MO 63080 Phone: 573-468-3289 Fax: 573-468-3303
Dr. Aaron Chauncey Rowbottom, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 675 Dunsford Dr, Sullivan, MO 63080 Phone: 573-468-2774 Fax: 573-468-2008

Tae Ho Kong, DDS - Medicare Dentist in Sullivan, MO