Individual provider Active NPI

Sunny E Kim, D.D.S.

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1114070810
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
BK5587019 Issued in WA
Practice address
3650 Wallingford Ave N
Seattle, WA 98103-8242
Phone
(206) 634-2022
Fax
(206) 634-9460
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X BK5587019 WA Primary

Addresses

Primary practice location

3650 Wallingford Ave N
Seattle, WA 98103-8242

Mailing address

3650 Wallingford Ave N
Seattle, WA 98103-8242
Phone (206) 634-2022

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

LicenseStateTypeSpecialty
BK5587019WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny E. Kim DDS PLLC Current Accepting new patients

Locations

3333 Wallingford Ave N
Ste C4
Seattle, WA 98103
Phone (206) 634-2022

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114070810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 WALLINGFORD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038242",
            "telephone_number": "206-634-2022",
            "fax_number": "206-634-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 WALLINGFORD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038242",
            "telephone_number": "206-634-2022",
            "fax_number": "206-634-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUNNY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "BK5587019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

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.

Verify at the official NPI Registry.