Active NPI
Jonathan J Kim, D.D.S.
- Dentist
- Fishkill, NY
National Provider Identifier
1104036797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48088
- Practice address
- 2 Summit CT
Suite 206
Fishkill, NY 12524-1348 - Phone
- (845) 896-9192
- NPI assigned
- May 23, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 48088 | NY | Primary |
Addresses
Primary practice location
2 Summit CT
Suite 206
Fishkill, NY 12524-1348
Mailing address
23 Greenwich Ave
Central Valley, NY 10917-3717
Phone (845) 827-6470
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 |
|---|---|---|---|
| 48088 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104036797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 GREENWICH AVE",
"city": "CENTRAL VALLEY",
"state": "NY",
"postal_code": "109173717",
"telephone_number": "845-827-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SUMMIT CT",
"address_2": "SUITE 206",
"city": "FISHKILL",
"state": "NY",
"postal_code": "125241348",
"telephone_number": "845-896-9192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JONATHAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "48088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fishkill, NY
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.