Individual provider Active NPI

Sangmee Kim, DDS

  • Pediatric Dentistry
  • Clifton Park, NY
National Provider Identifier
1093370801
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
062060 Issued in NY
Practice address
713 Pierce Rd
Clifton Park, NY 12065-1302
Phone
(518) 373-1181
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 062060 NY Primary
Pediatric Dentistry 1223P0221X 062060-01 NY

Addresses

Primary practice location

713 Pierce Rd
Clifton Park, NY 12065-1302

Mailing address

713 Pierce Rd
Clifton Park, NY 12065
Phone (518) 373-1181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190729000574 CT Order and Referring Only - DentistPractitioner - Dentist 1557697687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062060NYMDPediatric Dentist
062060-01NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonnell and McMahon Pediatric Dentistry PLLC Pediatric Dentistry PastSince Oct 5, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1093370801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 PIERCE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-373-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 PIERCE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120651302",
            "telephone_number": "518-373-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANGMEE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "062060",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "062060-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.