Kristine Eunsong Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12497 Issued in MD

Practice address

3233 Superior Lane
Suite B-25
Bowie, MD 20715

Phone

(301) 262-3535

Fax

(301) 464-3478

NPI assigned

Jul 2, 2014

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Cho, Formica, Love & Associates, P.a.

  • General Practice Dentistry
  • Bowie, MD
  • NPI 1104418896
  NPD Authorized official
• Gordon Formica & Love DDS PA

  • Dentist
  • Bowie, MD
  • NPI 1356441612
  NPD (past)
• Smile Loft - Bowie LLC

  • General Practice Dentistry
  • Bowie, MD
  • NPI 1730953613
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1285040998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 SUPERIOR LANE",
            "address_2": "SUITE B-25",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20715",
            "telephone_number": "301-262-3535",
            "fax_number": "301-464-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 SUPERIOR LANE",
            "address_2": "SUITE B-25",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20715",
            "telephone_number": "301-262-3535",
            "fax_number": "301-464-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KRISTINE",
        "middle_name": "EUNSONG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aatifa Kalim Khan, D.D.S.
• Agnes Khumbah
• Beserat Legesse Kibret, NURSE PRACTITIONER
• Mary Gfumbo Killah Ajabmoh
• Angela Kim, DPT
• Kimberly M Brooks, PHD, Inc.
• Yanick Kimbi Fai
• Kindhearted Healthcare Services Inc.
• Kindhearted Healthcare Services Inc.
• Kinetic Care Therapy LLC

• General Practice Dentistry in Bowie, MD
• Providers in Bowie, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.