Individual provider Active NPI

Daniel Kim

  • General Practice Dentistry
  • Dalton, GA
National Provider Identifier
1376265736
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122877 Issued in GA
Practice address
1006 Professional Blvd Unit B
Dalton, GA 30720-2715
Phone
(706) 226-2228
NPI assigned
Sep 13, 2022
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN122877 GA Primary

Addresses

Primary practice location

1006 Professional Blvd Unit B
Dalton, GA 30720-2715

Mailing address

1006 Professional Blvd Unit B
Dalton, GA 30720-2715

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
DN122877GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Brainerd Dental PLLC Current Accepting new patients
Lee-Voegele LLC CurrentSince Nov 6, 2022 Accepting new patients

Locations

1006 Professional Blvd
Unit B
Dalton, GA 30720
Phone (706) 226-2228

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1376265736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 PROFESSIONAL BLVD UNIT B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 PROFESSIONAL BLVD UNIT B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202715",
            "telephone_number": "706-226-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.