Dentlife Dental Care

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTLIFE DENTAL CARE

Practice address

27087 Lorain Rd
North Olmsted, OH 44070-3213

Phone

(440) 471-4098

NPI assigned

Mar 17, 2023

Organization subpart

No

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

Authorized official

Name

Dug Soo KimNPI 1114332046

Title

Owner/DMD

Phone

(440) 471-4098

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dug Soo Kim, DMD

  • General Practice Dentistry
  • North Olmsted, OH
  • NPI 1114332046
  NPD Authorized official

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1184325979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27087 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703213",
            "telephone_number": "440-471-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27087 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703213",
            "telephone_number": "440-471-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTLIFE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DUG SOO",
        "authorized_official_title_or_position": "OWNER/DMD",
        "authorized_official_telephone_number": "440-471-4098"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114332046",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willie Dean Davis
• Harold V Dennison III, CDCA
• Rhonda Gail Dennstedt, RN
• Dental Professionals Cleveland-Nouneh, Inc.
• Terence Robert Dentkos, DDS, MS
• Megan Burdick Desimone, DDS
• Jesse Desoto, PHARM.D, RPH
• James Allen Devengencie, D.D.S., M.S.
• Anthony Dibiasio, PH.D.
• Lauren Dietrich

• Dental Clinic/Center in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.