Min H Kim, D.D.S

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DJ02489100 Issued in NJ

Practice address

10 N Gaston Ave
Somerville, NJ 08876

Phone

(908) 218-0770

Fax

(908) 218-9789

NPI assigned

Sep 16, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• CTP Dental LLC

  • General Practice Dentistry
  • Raritan, NJ
  • NPI 1285482745
  NPD Authorized official
• Kim and Kim DDS LLC

  • Periodontics
  • Somerville, NJ
  • NPI 1669941696
  NPD Authorized official
• Jacoby & Morris DDS

  • General Practice Dentistry
  • Ho Ho Kus, NJ
  • NPI 1336306638
  NPD (past)

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1134555667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N GASTON AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "08876",
            "telephone_number": "908-218-0770",
            "fax_number": "908-218-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N GASTON AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "08876",
            "telephone_number": "908-218-0770",
            "fax_number": "908-218-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 First St.",
            "address_purpose": "LOCATION",
            "city": "Ho Ho Kus",
            "state": "NJ",
            "postal_code": "07423",
            "country_code": "US",
            "telephone_number": "201-652-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-16",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "50056960",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DJ02489100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "22DJ02489100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saba Khan, PSYD
• Vimi Khattar, M.D.
• Kim and Kim DDS LLC
• Henry Kim, MD
• Kevin HS Kim, PHARMD
• Kimberly D. Goodrich, LCSW L.L.C.
• Amanda Katelynn Kix, ED.S.
• Samantha A Knieser, AGACNP-BC
• Kelly Koeller, LCSW
• Caitlin Kondroski

• Periodontics in Somerville, NJ
• Providers in Somerville, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.