Active NPI
Daniel Kim, DDS
- General Practice Dentistry
- Sykesville, MD
National Provider Identifier
1407039423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14113
- Practice address
- 2030 Liberty Rd
Sykesville, MD 21784-6129 - Phone
- (410) 781-7188
- Fax
- (410) 781-0269
- NPI assigned
- Dec 12, 2007
- Last updated
- Dec 12, 2007
- Sex
- Male
- 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 | 14113 | MD | Primary |
Addresses
Primary practice location
2030 Liberty Rd
Sykesville, MD 21784-6129
Mailing address
2030 Liberty Rd
Sykesville, MD 21784-6129
Phone (410) 781-7188
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 |
|---|---|---|---|
| 14113 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jasthi-Park & Associates | General Practice | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Eldersburg, MD
- NPI 1538481569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197417600000",
"number": "1407039423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2030 LIBERTY RD",
"city": "SYKESVILLE",
"state": "MD",
"postal_code": "217846129",
"telephone_number": "410-781-7188",
"fax_number": "410-781-0269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 LIBERTY RD",
"city": "SYKESVILLE",
"state": "MD",
"postal_code": "217846129",
"telephone_number": "410-781-7188",
"fax_number": "410-781-0269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-12",
"last_updated": "2007-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "14113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sykesville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.