Sean Shin Kim

Primary specialty

DentistTaxonomy code 122300000X

License

056133 Issued in NY

Practice address

152 N Wellwood Ave
Lindenhurst, NY 11757-4046

Phone

(631) 226-1155

NPI assigned

Jun 6, 2011

Sex

Male

Sole proprietor

Yes

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.

• Robert B Garelick DDS PC

  • Dentist
  • Lindenhurst, NY
  • NPI 1952750937
  NPD (past)

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073807103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 PLATEAU AVE # 2",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241726",
            "telephone_number": "201-600-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 N WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574046",
            "telephone_number": "631-226-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEAN",
        "middle_name": "SHIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akbar Khan, M.D.
• Durdana Khan
• Jonathan J Khodadadian, MD
• Parvis K. Khodadadian, MD
• Peter G Killian, RN
• King Kullen Pharmacy
• Alissa King
• Alexa Brynn Klein, LCSW
• Jonathan Klug, M.D.
• Stephanie Kneessy, LMSW

• Dentist in Lindenhurst, NY
• Providers in Lindenhurst, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.