Individual provider Active NPI

Michelle Kim, D.D.S.

  • Dentist
  • Marion, NC
National Provider Identifier
1013251271
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11705 Issued in NC
Practice address
2218 Rutherford Rd Ste a
Marion, NC 28752-5368
Phone
(828) 652-2731
Fax
(931) 762-3991
NPI assigned
Nov 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9571 TN
Dentist 122300000X 11705 NC Primary

Addresses

Primary practice location

2218 Rutherford Rd Ste a
Marion, NC 28752-5368

Mailing address

2218 Rutherford Rd Ste a
Marion, NC 28752-5368
Phone (828) 652-2731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411002105 NC Practitioner - Dentist 5294023701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9571TNMDDentist
11705NCMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Erin Rake, DDS, P.C. Dentist CurrentSince Feb 24, 2025 Accepting new patients

Locations

8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112

201 McCullough Dr
Ste 180
Charlotte, NC 28262
Phone (704) 228-8495

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1013251271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 RUTHERFORD RD STE A",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287525368",
            "telephone_number": "828-652-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 RUTHERFORD RD STE A",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287525368",
            "telephone_number": "828-652-2731",
            "fax_number": "931-762-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHELLE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-12",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9571",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, NC

Sources for this page

Verify at the official NPI Registry.