Individual provider Active NPI

Christine H Kim, D.M.D.

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1215017520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00006478 Issued in WA
Practice address
11066 5TH Ave NE
Suite # 105
Seattle, WA 98125-6156
Phone
(206) 362-6331
Fax
(206) 362-2072
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00006478 WA Primary

Addresses

Primary practice location

11066 5TH Ave NE
Suite # 105
Seattle, WA 98125-6156

Mailing address

11066 5TH Ave NE
Suite # 105
Seattle, WA 98125-6156
Phone (206) 362-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20160819001500 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6507151222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00006478WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jieun Choi, DMD, PLLC PastSince Feb 9, 2020 Accepting new patients
Christine H. Kim, D.M.D. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215017520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11066 5TH AVE NE",
            "address_2": "SUITE # 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256156",
            "telephone_number": "206-362-6331",
            "fax_number": "206-362-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11066 5TH AVE NE",
            "address_2": "SUITE # 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256156",
            "telephone_number": "206-362-6331",
            "fax_number": "206-362-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTINE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.