Active NPI
Kimberly M Lim, DDS
- General Practice Dentistry
- Kennesaw, GA
National Provider Identifier
1073524765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN012586
- Practice address
- 3104 Creekside Village Dr NW
Suite 301
Kennesaw, GA 30144-2324 - Phone
- (770) 974-8211
- NPI assigned
- Aug 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN012586 | GA | Primary |
Addresses
Primary practice location
3104 Creekside Village Dr NW
Suite 301
Kennesaw, GA 30144-2324
Mailing address
3104 Creekside Village Dr NW
Suite 301
Kennesaw, GA 30144-2324
Phone (770) 974-8211
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 |
|---|---|---|---|
| DN012586 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073524765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3104 CREEKSIDE VILLAGE DR NW",
"address_2": "SUITE 301",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442324",
"telephone_number": "770-974-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3104 CREEKSIDE VILLAGE DR NW",
"address_2": "SUITE 301",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442324",
"telephone_number": "770-974-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "KIMBERLY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN012586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- 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.