Active NPI
Chulhwan J Kim, DMD
- Dentist
- Bloomfield, CT
National Provider Identifier
1023193448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9483
- Practice address
- 11 Mountain Ave
Suite 107
Bloomfield, CT 06002-2343 - Phone
- (860) 242-1044
- Fax
- (860) 242-8568
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9483 | CT | Primary |
Addresses
Primary practice location
11 Mountain Ave
Suite 107
Bloomfield, CT 06002-2343
Mailing address
11 Mountain Ave
Suite 107
Bloomfield, CT 06002-2343
Phone (860) 242-1044
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 |
|---|---|---|---|
| 9483 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northampton Family Dentistry PC | Dentist | Past | Accepting new patients |
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.
-
- Dentist
- Northampton, MA
- NPI 1861896862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404172800000",
"number": "1023193448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 MOUNTAIN AVE",
"address_2": "SUITE 107",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060022343",
"telephone_number": "860-242-1044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 MOUNTAIN AVE",
"address_2": "SUITE 107",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060022343",
"telephone_number": "860-242-1044",
"fax_number": "860-242-8568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHULHWAN",
"middle_name": "J",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2014-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "9483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.