NPIMap

Organization Active NPI

Ji S Kim DDS PLLC

  • General Practice Dentistry
  • Redford, MI
National Provider Identifier
1205110293
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901019035 Issued in MI
Legal business name
JI S KIM DDS PLLC
Practice address
26750 Grand River Ave
Redford, MI 48240-1529
Phone
(313) 531-2000
Fax
(313) 531-1063
NPI assigned
Oct 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Authorized official

Name
Ji KimNPI 1740357755
Title
Owner/Dentist
Phone
(313) 531-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901019035 MI Primary

Addresses

Primary practice location

26750 Grand River Ave
Redford, MI 48240-1529

Mailing address

26750 Grand River Ave
Redford, MI 48240-1529
Phone (313) 531-2000

National Provider Directory

National Provider Directory

Locations

26750 Grand River Ave
Redford, MI 48240
Phone (313) 531-2000

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1205110293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26750 GRAND RIVER AVE",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401529",
            "telephone_number": "313-531-2000",
            "fax_number": "313-531-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26750 GRAND RIVER AVE",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401529",
            "telephone_number": "313-531-2000",
            "fax_number": "313-531-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JI S KIM DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JI",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "313-531-2000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.