Amelia Chim

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE60470450 Issued in WA

Practice address

4200 Mary Gates Memorial Dr NE Apt U253
Seattle, WA 98105-5649

Phone

(206) 383-9338

NPI assigned

Mar 31, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mint Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Bellevue, WA
  • NPI 1336078385
  NPD Authorized official
• North Bend Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • North Bend, WA
  • NPI 1568287258
  NPD Authorized official
• Plateau Kids Dentistry, LLC

  • Pediatric Dentistry
  • Sammamish, WA
  • NPI 1740807890
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1003234899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 MARY GATES MEMORIAL DR NE APT U253",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 MARY GATES MEMORIAL DR NE APT U253",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055649",
            "telephone_number": "206-383-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIM",
        "first_name": "AMELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60470450",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00007833",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60470450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coburn Kirby Childs, LMHCA
• Taylor O Childs, ARNP, DNP
• Tiffany Capri Childs
• Gabrielle Chille
• Hailey Alexa Chillem
• Kannie Chim, MD
• Ashiedu Chima, LMT
• Tara Chin-Sang, LMP
• Alan Chin, PHARMD
• Alisa Senitha Chin

• Pediatric Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.