Irene T Kim, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

061036 Issued in NY

Practice address

225 E 64TH St Ste 1
New York, NY 10065-6684

Phone

(212) 838-0940

NPI assigned

Jul 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1003339953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E 50TH ST APT 14A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100227941",
            "telephone_number": "443-813-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 64TH ST STE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656684",
            "telephone_number": "212-838-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "IRENE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "061036",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilya I Kim, MD
• Inho Kim, M.D.
• Innae Julia Kim
• Ireh Kim
• Ireh Kim
• Isaac Young Kim, DO
• Ja Young Kim
• Jacob Junhyung Kim
• Jacqueline Kim
• Jae Keaun Kim

• Periodontics in New York, NY
• Providers in New York, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.