Active NPI
Janice S Kim, DMD
- Dentist
- El Paso, TX
National Provider Identifier
1235534157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30748
- Practice address
- 5005 N Piedras St
Attn Dentac
El Paso, TX 79920-5001 - Phone
- (915) 742-5935
- NPI assigned
- Nov 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30748 | TX | Primary |
Addresses
Primary practice location
5005 N Piedras St
Attn Dentac
El Paso, TX 79920-5001
Mailing address
428 Grand Avenue Parkway
Suite150
Pflugerville, TX 78660
Phone (512) 649-2828
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 |
|---|---|---|---|
| 30748 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K Family Dentistry | Current | Accepting new patients |
Locations
428 Grand Avenue Pkwy
Ste 150
Pflugerville, TX 78660
Phone (216) 225-5969
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.
-
- Dental Clinic/Center
- Pflugerville, TX
- NPI 1275186264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576627200000",
"number": "1235534157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "428 GRAND AVENUE PARKWAY",
"address_2": "SUITE150",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "78660",
"telephone_number": "512-649-2828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5005 N PIEDRAS ST",
"address_2": "ATTN DENTAC",
"city": "EL PASO",
"state": "TX",
"postal_code": "799205001",
"telephone_number": "915-742-5935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JANICE",
"middle_name": "S",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-04",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.