Dae Ho Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60307878 Issued in WA

Practice address

5929 Evergreen Way Ste 100
Everett, WA 98203-6031

Phone

(425) 353-4469

Fax

(425) 348-5216

NPI assigned

Oct 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dkim452750@direct.multicare.org
• Direct secure messaging: dkim1186414@wm.providencedirect.org

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.

• Dae Ho Kim DDS PC Inc

  • Dentist
  • Everett, WA
  • NPI 1386053973
  NPD (past)
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1477911410

  Dentist

  NPD (past)

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1275869000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY STE 100",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-353-4469",
            "fax_number": "425-348-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY STE 100",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-353-4469",
            "fax_number": "425-348-5216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 100th St SE Ste C2",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982083832",
            "country_code": "US",
            "telephone_number": "425-249-0770",
            "fax_number": "425-249-0771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAE HO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-29",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60307878",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60307878",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2071188",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019027981",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Trieu, DDS, PLLC
• Alice Kim, PHARMD
• Bryan Kim, MD
• Caleb Youngho Kim
• Charles Junghyun Kim, DDS
• Daniel Byeongheui Kim, MD
• Darran Kim, OD
• David Eugene Kim, DPT
• Duk Soo Kim, DO
• Edwin Gi Lim Kim, DMD

• General Practice Dentistry in Everett, WA
• Providers in Everett, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.