Active NPI
Julie C. Kim, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1043871072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019022406
- Practice address
- 3258 W Lawrence Ave
Chicago, IL 60625-5223 - Phone
- (773) 478-3258
- Fax
- (773) 478-3103
- NPI assigned
- Jun 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 019022406 | IL | Primary |
Addresses
Primary practice location
3258 W Lawrence Ave
Chicago, IL 60625-5223
Mailing address
3258 W Lawrence Ave
Chicago, IL 60625-5223
Phone (773) 478-3258
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 |
|---|---|---|---|
| 019022406 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Dental Center, P.C. | 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
- Chicago, IL
- NPI 1235521584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560988800000",
"number": "1043871072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3258 W LAWRENCE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606255223",
"telephone_number": "773-478-3258",
"fax_number": "773-478-3103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3258 W LAWRENCE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606255223",
"telephone_number": "773-478-3258",
"fax_number": "773-478-3103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JULIE",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-20",
"last_updated": "2019-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019022406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.