Alden Kyu Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI01900800 Issued in NJ

Practice address

27 N Broadway
Gloucester City, NJ 08030-1156

Phone

(856) 456-0164

Fax

(856) 456-7683

NPI assigned

Apr 15, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144494840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 N BROADWAY",
            "city": "GLOUCESTER CITY",
            "state": "NJ",
            "postal_code": "080301156",
            "telephone_number": "856-456-0164",
            "fax_number": "856-456-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 N BROADWAY",
            "city": "GLOUCESTER CITY",
            "state": "NJ",
            "postal_code": "080301156",
            "telephone_number": "856-456-0164",
            "fax_number": "856-456-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALDEN",
        "middle_name": "KYU",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01900800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloucester City Board of Education
• Kristina M Greco, LCSW
• Healthy Smiles of Gloucester City
• Andrew Edward Herman, DC
• Daniel J Hyman, DO
• Hannah Kim
• Karen Jane Kirby, LCSW,LCADC
• Steven Klein, DO MPH
• Mast Ventures, Inc (MAST VENTURES, INC dba Always Best Care)
• Mediline Corporation (Gloucester City Pharmacy and Discount Store)

• General Practice Dentistry in Gloucester City, NJ
• Providers in Gloucester City, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.