Active NPI
Kenny Lim, DDS
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1134400377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 27283
- Practice address
- 115 W Seminary Dr Ste 101
Fort Worth, TX 76115-2603 - Phone
- (817) 529-0855
- NPI assigned
- Sep 1, 2011
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 27283 | TX | Primary |
Addresses
Primary practice location
115 W Seminary Dr Ste 101
Fort Worth, TX 76115-2603
Mailing address
115 W Seminary Dr Ste 101
Fort Worth, TX 76115-2603
Phone (817) 529-0855
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 |
|---|---|---|---|
| 27283 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bob Jing D.D.S P.a. | Past | 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": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314835200000",
"number": "1134400377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 W SEMINARY DR STE 101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761152603",
"telephone_number": "817-529-0855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W SEMINARY DR STE 101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761152603",
"telephone_number": "817-529-0855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "KENNY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-01",
"last_updated": "2011-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "27283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.