Sora Kim

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013594 Issued in GA

Practice address

330 Corporate Center CT
Ste a
Stockbridge, GA 30281-6360

Phone

(678) 289-6707

Fax

(850) 837-2042

NPI assigned

Jul 23, 2007

Last updated

Jul 23, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stockbridge Dental Group

  • General Practice Dentistry
  • Stockbridge, GA
  • NPI 1528107943
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1164622635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CORPORATE CENTER CT",
            "address_2": "STE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816360",
            "telephone_number": "678-289-6707",
            "fax_number": "850-837-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CORPORATE CENTER CT",
            "address_2": "STE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816360",
            "telephone_number": "678-289-6707",
            "fax_number": "850-837-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SORA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navita Khatri, DPM
• Kids First Pediatric Group, LLC
• Lindsey Kiesgen, AU.D.
• Alen Crystal Kim
• Diana Kim, D.O.
• Daphene Luvata Kimball-Butler, RN.PCM.CLC.SANE.
• Nia Louise Kimbro, FNP
• Joshua A King, MD
• Karyn L King, LPC, CPCS
• Elicia Kinney

• General Practice Dentistry in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• General Practice Dentistry in Georgia

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