Andrew Kim

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

29894 Issued in TX

Practice address

2722 W Grand Pkwy N # 200
Katy, TX 77449

Phone

(832) 906-3108

NPI assigned

Feb 14, 2011

Last updated

Dec 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

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.

• Andrew Kim Dental, PLLC

  dba Dentalopolis

  • Dental Clinic/Center
  • Spring, TX
  • NPI 1033983838
  NPD Authorized official
• Ideal Dental of Katy PLLC

  • Dentist
  • Katy, TX
  • NPI 1548611635
  NPD (past)

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1083911846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840641",
            "telephone_number": "972-361-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 W GRAND PKWY N # 200",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77449",
            "telephone_number": "832-906-3108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 W 34th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900890641",
            "country_code": "US",
            "telephone_number": "213-740-1545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 W 34th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900890641",
            "country_code": "US",
            "telephone_number": "213-740-1545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-14",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "58699",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "29894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidstown Dental
• Dennis Kiecke, P.T.
• Gerard Nyunwu Kiffa
• Rosemary Nsum Kiffa
• Amy Marie Kiley, PHARMD
• Edward S Kim, DDS
• Jaibum Kim, DDS, MS
• Jonathan T Kim, MD
• Samuel Young Kim, M.D.
• Sejoon Sean Kim, D.D.S. M.D.

• Periodontics in Katy, TX
• Providers in Katy, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.