Dr Songhyon Kim, DDS in Parker, AZ - Medicare Dentist Provider

Dr Songhyon Kim, DDS is a medicare enrolled "Dentist" provider in Parker, Arizona. His current practice location is 12033 Agency Rd, Parker, Arizona. You can reach out to his office (for appointments etc.) via phone at (928) 669-2137.

Dr Songhyon Kim is licensed to practice in Utah (license number 265201-9923) 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 1912076738.

Contact Information

	Dr Songhyon Kim, DDS
	12033 Agency Rd, Parker, AZ 85344-7718
	(928) 669-2137
	(928) 669-3131

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Songhyon Kim
Gender	Male
Speciality	Dentist
Location	12033 Agency Rd, Parker, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912076738
Provider Enumeration Date: 11/07/2006
Last Update Date: 08/15/2025

Medicare PECOS Information:

PECOS PAC ID: 7810218120
Enrollment ID: I20250604001740

Medical Identifiers

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

Identifier	Type	State	Issuer
1912076738	NPI	-	NPPES
1912076738	Medicaid	UT

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	30.025304 (Ohio)	Secondary
122300000X	Dentist	D10160 (Oregon)	Secondary
122300000X	Dentist	265201 (Utah)	Secondary
122300000X	Dentist	265201-9923 (Utah)	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. Dr Songhyon Kim allows following entities to bill medicare on his behalf.

Entity Name	Dhhs Ihs Phoenix Area
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396022026 PECOS PAC ID: 0244405629 Enrollment ID: O20120105000013

Entity Name	Dhhs Ihs Phoenix Area
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265719934 PECOS PAC ID: 7810163011 Enrollment ID: O20120109000961

Entity Name	Irene Benn Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841535317 PECOS PAC ID: 0840430724 Enrollment ID: O20130717000832

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 Songhyon 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
Dr Songhyon Kim, DDS Po Box 95461, Cleveland, OH 44101-0033 Ph: (928) 669-2137	Dr Songhyon Kim, DDS 12033 Agency Rd, Parker, AZ 85344-7718 Ph: (928) 669-2137

Reviews and Comments

Dentist in Parker, AZ

Dr. Mona Chami, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 12033 Agency Rd, Parker, AZ 85344 Phone: 928-669-3154 Fax: 928-669-3151
Dr. Heather Judd, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 12033 Agency Rd, Parker, AZ 85344 Phone: 928-669-3154
Dr. Mohammad Walid Omary, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 155 W Riverside Dr, Parker, AZ 85344 Phone: 928-669-0099
Dr. John Charles Boykin Iii, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 12033 Agency Rd, Parker, AZ 85344 Phone: 928-669-2137 Fax: 928-669-3353
Larry E Mcentire, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1220 W Arizona Ave, Parker, AZ 85344 Phone: 928-669-2573 Fax: 928-669-5953
Randall B. Smith, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: Parker Indian Health Cernter, 12033 Agency Rd., Parker, AZ 85344 Phone: 928-669-3162
Bernard Kirsch Beriau, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 12033 Agency Rd, Parker, AZ 85344 Phone: 928-669-3154

Dr Songhyon Kim, DDS - Medicare Dentist in Parker, AZ