Active NPI
Vivian Jiyoung Kim, D.D.S.
- General Practice Dentistry
- Paterson, NJ
National Provider Identifier
1356865745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI02685100
- Practice address
- 32 Clinton St
Paterson, NJ 07522 - Phone
- (973) 790-6594
- NPI assigned
- Jul 27, 2017
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02685100 | NJ | Primary |
Addresses
Primary practice location
32 Clinton St
Paterson, NJ 07522
Mailing address
67 Lakeview Ave Apt B
Leonia, NJ 07605
Phone (703) 463-0043
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 |
|---|---|---|---|
| 22DI02685100 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502150400000",
"number": "1356865745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 LAKEVIEW AVE APT B",
"city": "LEONIA",
"state": "NJ",
"postal_code": "07605",
"telephone_number": "703-463-0043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 CLINTON ST",
"city": "PATERSON",
"state": "NJ",
"postal_code": "07522",
"telephone_number": "973-790-6594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "VIVIAN",
"middle_name": "JIYOUNG",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-27",
"last_updated": "2017-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02685100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paterson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.