Min Jung Kim

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02791400 Issued in NJ

Practice address

220 Madison Ave Ste a
New York, NY 10016-3422

Phone

(212) 880-2222

NPI assigned

Mar 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1083116156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AVE AT PORT IMPERIAL BLVD APT 709",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070866106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MADISON AVE STE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163422",
            "telephone_number": "212-880-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIN JUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061567",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02791400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Millie Kim
• Mily Kim, DAOM
• Min Hee Kim, PHARMD
• Min Hi Kim, NP
• Min Jin Kim
• Min Jung Kim, DMD
• Min Jung Kim, L.A.C
• Min Seok Kim, DDS
• Mina C Kim, D.D.S.
• Mina Monica Kim

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.