Individual provider Active NPI

Rosy Minhye Kim, DDS

  • Dental Anesthesiology
  • Bridgeport, CT
National Provider Identifier
1285157487
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
GA2011 Issued in CA
Practice address
144 Boston Ave
Bridgeport, CT 06610-1604
Phone
(475) 422-8761
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS043043 PA
Dentist 122300000X 101567 CA
General Practice Dentistry 1223G0001X 13317 CT
Dental Anesthesiology 1223D0004X GA2011 CA Primary

Addresses

Primary practice location

144 Boston Ave
Bridgeport, CT 06610-1604

Mailing address

760 Route 46 # 1019
Parsippany, NJ 07054-3401
Phone (909) 296-2338

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

LicenseStateTypeSpecialty
101567CAMDDentist
DS043043PAMDDentist
GA2011CAMDDentist Anesthesiologist
13317CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dream High Dental Anesthesia, LLC Dental Anesthesiology CurrentSince Mar 20, 2022 Accepting new patients

Locations

144 Boston Ave
Bridgeport, CT 06610
Phone (203) 437-7561

760 Route 46
#1019
Parsippany, NJ 07054

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.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1285157487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 ROUTE 46 # 1019",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070543401",
            "telephone_number": "909-296-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 BOSTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101604",
            "telephone_number": "475-422-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ROSY",
        "middle_name": "MINHYE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043043",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101567",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "13317",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CA",
            "license": "GA2011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.