Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Roderick Youngdo Kim, DDS, MD

Individual provider Oral & Maxillofacial Surgery (D.M.D.) · NPI 1689954562

Roderick Youngdo Kim, DDS, MD is a Maxillofacial Surgery in Fort Worth, Texas. Graduated from University of Michigan Medical School in 2015, 11 years ago. Practices with Oral and Maxillofacial Network PLLC, a 7-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
11
Trained at
University of Michigan Medical School
Licensed in
TX
In the registry since
2011
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1500 S Main St Dept OF
Fort Worth, TX 76104-4917
Phone: (817) 702-6936
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 32838 (TX)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 32838 (TX)

Record details

NPI number1689954562
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , MD
Sole proprietorYes
NPI enumeratedAugust 23, 2011
Last updated in NPPESJune 26, 2024
Certification dateJune 26, 2024
Mailing address1500 South Main, Department Of Omfs, Fort Worth, TX 76104

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolUNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated 2015 (11 years in practice)
Group practice Oral And Maxillofacial Network Pllc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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