Susan S Kim, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00009731 Issued in WA

Practice address

12600 SE 38TH St
Suite 110
Bellevue, WA 98006-6105

Phone

(425) 614-3000

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Susan Kim DDS

  • Pediatric Dentistry
  • Kirkland, WA
  • NPI 1265495196
  NPD (past) Authorized official
• Jimmy Yun & Susan Kim, DDS, PS

  • Pediatric Dentistry
  • Bellevue, WA
  • NPI 1356410955
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033219936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 SE 38TH ST",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980066105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 SE 38TH ST",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980066105",
            "telephone_number": "425-614-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUSAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00009731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sooyeon Kim, M.D.
• Stephen Joseph Kim, D.D.S.
• Steve Hoonsang Kim, M.D.
• Sun Hu Kim, PHARMD
• Sung Ho Kim, L.AC.
• Tae Ho Kim, DAC, EAMP
• Tae Hoon Kim
• Taehyung Kim
• Thomas Kim, D.C.
• Tory Lynn Kim, R.PH. PHARM.D. BCPS

• Pediatric Dentistry in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.