Jane Kim

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1857275 Issued in MA

Practice address

72 State Rd
North Dartmouth, MA 02747-2920

Phone

(508) 996-3360

NPI assigned

Aug 27, 2016

Last updated

Aug 27, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Jane C Kim DMD, PC D/B/a Omnidentix

  • Dental Clinic/Center
  • North Dartmouth, MA
  • NPI 1508411778
  NPD Authorized official

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

{
    "created_epoch": "1472256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472256000000",
    "number": "1275089682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 STATE RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027472920",
            "telephone_number": "508-996-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 STATE RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027472920",
            "telephone_number": "508-996-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-27",
        "last_updated": "2016-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kem Optical P.C.
• Ashley Marie Curran Kenyon, DO
• Kenneth Ralph Kenyon, M.D.
• Jessica Lynn Keough, NP
• Yvonne Khazen, P.A.
• Wendy M Kirby, LATC
• Kara J. Kopaczewski, DO
• Erin K Kopecky, NURSE PRACTITIONER
• Drew Labossiere
• Joy H Ladd, OTR

• General Practice Dentistry in North Dartmouth, MA
• Providers in North Dartmouth, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.