John M Kim DMD PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

014347 Issued in MI

Legal business name

JOHN M KIM DMD PC

Practice address

3102 Niles Rd
Saint Joseph, MI 49085-8609

Phone

(269) 429-7122

Fax

(269) 429-6410

NPI assigned

Sep 9, 2010

Organization subpart

No

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

Authorized official

Name

Cindy Mitowski

Title

Office Manager

Phone

(269) 429-7122

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• John M Kim DMD Other name

Locations

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1144537333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858609",
            "telephone_number": "269-429-7122",
            "fax_number": "269-429-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858609",
            "telephone_number": "269-429-7122",
            "fax_number": "269-429-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M KIM DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "MITOWSKI",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-429-7122"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "014347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2983370",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John M Kim DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Katharine Jarpe, LMSW
• Caroline Jarvis, LAT, ATC
• Philip Jasheway, PT, AT
• Jason R Beckrow DO PC
• Leann Jewell, PT
• John M. Stafford, MD, and Associates, P.C.
• Benjamin W Johnson, LLPC
• Erica Johnson, PA-C
• Ewanah D Johnson, MD
• Fanny Alaez Johnson, MA

• Oral and Maxillofacial Surgery (Dentist) in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.