Dr Yong Soo Kim, DDS in Fort Irwin, CA - Dentist

Dr Yong Soo Kim, DDS is a Dentist - General Practice based in Fort Irwin, California. Dr Yong Soo Kim is licensed to practice in Utah (license number 7113006-9921) and his current practice location is 171 Inner Loop Rd, Fort Irwin, California. He can be reached at his office (for appointments etc.) via phone at (760) 380-3166.

NPI number for Dr Yong Soo Kim is 1265684161 and his current mailing address is Shuttleworth Dental Clinic, 171 Inner Loop Rd., Fort Irwin, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1265684161.

Contact Information

	Dr Yong Soo Kim, DDS
	171 Inner Loop Rd, Fort Irwin, CA 92310
	(760) 380-3166
	Not Available

Healthcare Provider's Profile

Full Name	Dr Yong Soo Kim
Gender	Male
Speciality	Dentist - General Practice
Location	171 Inner Loop Rd, Fort Irwin, California
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1265684161
Provider Enumeration Date: 10/22/2008
Last Update Date: 12/20/2023

Medical Identifiers

Medical identifiers for Dr Yong Soo Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265684161	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	7113006 (Utah)	Secondary
1223G0001X	Dentist - General Practice	7113006-8903 (Utah)	Secondary
1223G0001X	Dentist - General Practice	7113006-9921 (Utah)	Primary

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. Dr Yong Soo Kim is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Yong Soo Kim, DDS Shuttleworth Dental Clinic, 171 Inner Loop Rd., Fort Irwin, CA 92310-5080 Ph: (760) 380-3166	Dr Yong Soo Kim, DDS 171 Inner Loop Rd, Fort Irwin, CA 92310 Ph: (760) 380-3166

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Dentist in Fort Irwin, CA

Dr. Stephanie Chung Lee, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Road, Fort Irwin, CA 92310 Phone: 760-380-3166
Ryan Steven Payne, Dentist Medicare: Not Enrolled in Medicare Practice Location: 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 Phone: 719-526-5537 Fax: 706-787-2082
Dr. Brent Wayne Clark, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 390 North Loop Rd., Fort Irwin, CA 92310 Phone: 760-383-5289
Dr. Joshua Hyungkyu Lee, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4th And Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 Phone: 719-526-5537
Dr. Sergio Hernandez, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 171 Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-3173
Dr. Dolores Luque, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: Building 171, 4th & Inner Loop Rd, Fort Irwin, CA 92310 Phone: 760-380-5733 Fax: 760-380-4996

Dr Yong Soo Kim, DDS - Dentist in Fort Irwin, CA