Active NPI
Yun Ae Kim, D.M.D
- Pediatric Dentistry
- Portland, ME
National Provider Identifier
1326494840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN5109
- Practice address
- 1 College St
Portland, ME 04103-2617 - Phone
- (207) 221-4717
- NPI assigned
- May 13, 2016
- Last updated
- Jan 8, 2025
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DEN5109 | ME | Primary |
Addresses
Primary practice location
1 College St
Portland, ME 04103-2617
Mailing address
9 Cole St Apt 12
South Portland, ME 04106-4210
Phone (508) 330-6242
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 |
|---|---|---|---|
| DEN5109 | ME | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1326494840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 COLE ST APT 12",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041064210",
"telephone_number": "508-330-6242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLLEGE ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032617",
"telephone_number": "207-221-4717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YUN",
"middle_name": "AE",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-13",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "ME",
"license": "DEN5109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.