Active NPI
Michelle Kim, D.D.S.
- Dentist
- Marion, NC
National Provider Identifier
1013251271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11705
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9571 | TN | MD | Dentist |
| 11705 | NC | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erin Rake, DDS, P.C. | Dentist | Current | 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
- Yolande Karsten
- Keith C Damico PA C Professional Association
- Keith C Damico Pac Professional Association (Terry McCall MD)
- Leah Rachelle Kelley, LPC
- Ashley Lynn Kelvy
- Adam Joseph Kinninger, D.O.
- Christopher Shawn Kirby
- Anne Perry Knight, RPH
- Audrey Jalaine Konigsberg, PA
- Lake James Lodge Assisted Living, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.