Active NPI
Bokhung Kim, D.M.D.
- Dentist
- New York, NY
National Provider Identifier
1275973901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS039550
- Practice address
- 29 E 21St St
New York, NY 10010-6209 - Phone
- (212) 686-3686
- NPI assigned
- Jun 26, 2013
- 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 | DS039550 | PA | Primary |
Addresses
Primary practice location
29 E 21St St
New York, NY 10010-6209
Mailing address
208 W 23Rd St
New York, NY 10011-2306
Phone (929) 263-4347
Other practice location 1
4512 New Falls Rd
Levittown, PA 19056-3011
Phone (267) 225-2654
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 |
|---|---|---|---|
| DS039550 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dear Dental PC | Current | Accepting new patients | |
| Life Bridge Dental PLLC | Dentist | Current | Accepting new patients |
Locations
890 Mountain Ave
Ste 310
New Providence, NJ 07974
Phone (551) 222-0072
29 E 21st St
New York, NY 10010
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.
-
- Dental Clinic/Center
- New Providence, NJ
- NPI 1174304216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1275973901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 W 23RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100112306",
"telephone_number": "929-263-4347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 E 21ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100106209",
"telephone_number": "212-686-3686"
}
],
"practiceLocations": [
{
"address_1": "4512 New Falls Rd",
"address_purpose": "LOCATION",
"city": "Levittown",
"state": "PA",
"postal_code": "190563011",
"country_code": "US",
"telephone_number": "267-225-2654",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "BOKHUNG",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-26",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.