NPIMap

Organization Active NPI

Tommy L Kim, DDS, PA

  • Dentist
  • Charlotte, NC
National Provider Identifier
1427227545
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7145 Issued in NC
Legal business name
TOMMY L KIM, DDS, PA
Doing business as
Prosperity Park Center for Dentistry
Practice address
10220 Prosperity Park Rd
Ste 100
Charlotte, NC 28269-1105
Phone
(704) 948-5684
NPI assigned
Feb 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Authorized official

Name
Dr. Tommy Lee Kim, DDSNPI 1295846293
Title
Owner/Doctor
Phone
(704) 948-5684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7145 NC Primary

Addresses

Primary practice location

10220 Prosperity Park Rd
Ste 100
Charlotte, NC 28269-1105

Mailing address

10220 Prosperity Park Rd
Ste 100
Charlotte, NC 28269-1105
Phone (704) 948-5684

Other names 1

  • Prosperity Park Center for Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

10220 Prosperity Park Dr
Ste 100
Charlotte, NC 28269
Phone (704) 948-5684

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1427227545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 PROSPERITY PARK RD",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691105",
            "telephone_number": "704-948-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 PROSPERITY PARK RD",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691105",
            "telephone_number": "704-948-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMMY L KIM, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "704-948-5684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosperity Park Center for Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.