Paul Kim

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1859542 Issued in MA

Practice address

110 Park St Unit 1
Chelsea, MA 02150-2709

Phone

(617) 466-2277

NPI assigned

Jul 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1417682865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 SAND POINT WAY NE UNIT 945",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PARK ST UNIT 1",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502709",
            "telephone_number": "617-466-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859542",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1859542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen H Kennedy, PT
• Lauren Kennedy
• Faiz Khan
• Angela Kilbride
• Emma Louise Killoran
• Lori Kirkman
• Genia Ann Kluba, MSW
• Eric Knudsen
• Grace Sayomi Koah
• Xue-Jun (June) Kong, M.D.

• General Practice Dentistry in Chelsea, MA
• Providers in Chelsea, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.