Active NPI
Eunlim Kim
- General Practice Dentistry
- Newark, DE
National Provider Identifier
1013640499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- G1-0011515
- Practice address
- 72 Omega Dr BLDG D
Newark, DE 19713-2063 - Phone
- (302) 738-3666
- NPI assigned
- Jul 5, 2022
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS043372 | PA | |
| General Practice Dentistry | 1223G0001X | G1-0011515 | DE | Primary |
Addresses
Primary practice location
72 Omega Dr BLDG D
Newark, DE 19713-2063
Mailing address
72 Omega Dr BLDG D
Newark, DE 19713-2063
Phone (302) 738-3666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G1-0011515 | DE | MD | General Practice Dentistry |
| DS043372 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1013640499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 OMEGA DR BLDG D",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132063",
"telephone_number": "302-738-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 OMEGA DR BLDG D",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132063",
"telephone_number": "302-738-3666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "EUNLIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-05",
"last_updated": "2022-09-02",
"certification_date": "2022-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS043372",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DE",
"license": "G1-0011515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.