MEDICARE: DR. YOUKYUNG KIM DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DE61476221	WA

General Provider Information

NPI Number	:	1396639175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOUKYUNG KIM DDS

Provider Business Mailing Address
First Line	:	3150 W GOVERNMENT WAY
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-1459
Country	:	US
Telephone Number	:	206-985-0232
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 W GOVERNMENT WAY
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-1459
Country	:	US
Telephone Number	:	206-985-0232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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Directions to “ DR. YOUKYUNG KIM DDS” Practice Location

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