Active NPI
Joshua Kim, DDS
- Dentist
- Gresham, OR
National Provider Identifier
1417455023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D10726
- Practice address
- 19059 SE Division St
Gresham, OR 97030-5165 - Phone
- (503) 661-4711
- NPI assigned
- Jan 29, 2018
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D10726 | OR | Primary |
Addresses
Primary practice location
19059 SE Division St
Gresham, OR 97030-5165
Mailing address
700 SE Cesar E Chavez Blvd Apt 307
Portland, OR 97214-3599
Phone (614) 571-5574
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 |
|---|---|---|---|
| D10726 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ritta Karam DMD Ma LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1417455023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 SE CESAR E CHAVEZ BLVD APT 307",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143599",
"telephone_number": "614-571-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19059 SE DIVISION ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970305165",
"telephone_number": "503-661-4711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOSHUA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D10726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.