DR. SONGHYON KIM (DDS) – Dentist, NPI 1912076738
Dentist
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
61 DENTIST in OH
Provider Addresses for DR. SONGHYON KIM (DDS)
4044 Morse Rd
Columbus, OH 432301448
Phone: (614) 473-0400
Fax: (913) 752-9116
Type: Location
992 Country Club Rd Ste 102
Eugene, OR 974016023
Phone: (855) 433-6825
Type: Location
2961 W Maple Loop Dr Ste 110
Lehi, UT 840435717
Phone: (801) 766-4042
Type: Location
PO BOX 95461
CLEVELAND, OH 441010033
Phone: (928) 669-2137
Fax: (928) 669-3131
Type: Mailing
12033 AGENCY RD
PARKER, AZ 853447718
Phone: (928) 669-2137
Fax: (928) 669-3131
Type: Location
4044, Morse Road, Easton Square, Columbus, Sharon, Franklin, Ohio, 43230, United States
COLUMBUS, OH 432301448
Phone: (614) 473-0400
Fax: (913) 752-9116
Type: Location
2800, Applewood Lane, Eugene, Lane County, Oregon, 97408, United States
EUGENE, OR 974081540
Phone: (801) 633-1919
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250604001740 | I | Dentist | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43230)
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