Active NPI
Raymond N Kim, DDS
- Dentist
- Las Vegas, NV
National Provider Identifier
1215940432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3336
- Practice address
- 7312 W Cheyenne Ave
Suie 3
Las Vegas, NV 89129-7428 - Phone
- (702) 396-9924
- Fax
- (702) 396-3735
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3336 | NV | Primary |
| Dentist | 122300000X | 43028 | CA |
Addresses
Primary practice location
7312 W Cheyenne Ave
Suie 3
Las Vegas, NV 89129-7428
Mailing address
7312 W Cheyenne Ave
Suie 3
Las Vegas, NV 89129-7428
Phone (702) 396-9924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43028 | CA | MD | Pharmacist |
| 3336 | NV | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pointe North Dental | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Public Health or Welfare Agency
- Las Vegas, NV
- NPI 1013013283
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215940432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7312 W CHEYENNE AVE",
"address_2": "SUIE 3",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891297428",
"telephone_number": "702-396-9924",
"fax_number": "702-396-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7312 W CHEYENNE AVE",
"address_2": "SUIE 3",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891297428",
"telephone_number": "702-396-9924",
"fax_number": "702-396-3735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "RAYMOND",
"middle_name": "N",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "3336",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "43028",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.