Individual provider Active NPI

Taeyun Kim, DDS

  • General Practice Dentistry
  • East Brunswick, NJ
National Provider Identifier
1063399848
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI03115800 Issued in NJ
Practice address
1070 State Route 18
East Brunswick, NJ 08816-4350
Phone
(609) 547-3232
NPI assigned
Aug 21, 2025
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI03115800 NJ Primary

Addresses

Primary practice location

1070 State Route 18
East Brunswick, NJ 08816-4350

Mailing address

416 Greenway Dr
Leonia, NJ 07605-1009
Phone (201) 699-8131

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

LicenseStateTypeSpecialty
22DI03115800NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cosmetic Dentistry and Implants CurrentSince Aug 25, 2025 Accepting new patients

Locations

1070 State Route 18
East Brunswick, NJ 08816
Phone (609) 547-3232

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1063399848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 GREENWAY DR",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051009",
            "telephone_number": "201-699-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 STATE ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164350",
            "telephone_number": "609-547-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAEYUN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI03115800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.