Miri Christine Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DTP789 Issued in FL

Practice address

3400 Gulf to Bay Blvd RM 2901E
Clearwater, FL 33759-4514

Phone

(210) 452-8349

NPI assigned

Aug 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Nova Southeastern Univ College of Dental Medicine, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Community Clinic of Maui, Inc.

  dba Malama I Ke Ola Health Center

  • Community Health Clinic/Center
  • Wailuku, HI
  • NPI 1528042561
  Medicare reassignment

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1407103831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N ROCKY POINT DR E UNIT 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076080",
            "telephone_number": "210-452-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 GULF TO BAY BLVD RM 2901E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594514",
            "telephone_number": "210-452-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIRI",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DTP789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids Talk LLC
• Donald G. Kikta Jr., M.D.
• Erin Marie Kilgore, PA
• Jessica Kilgore
• John E Kilgore, MD
• Alison M Kimball
• Jacqueline Kimball
• Jon Potter Kimball, MD
• Ralph D Kimbrough, DMD
• Meghan Roseann Kincaid

• Dentist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.