Minna Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00205298 Issued in CO

Practice address

2117 Custer Dr
Fort Collins, CO 80525-3684

Phone

(970) 221-3700

NPI assigned

Oct 13, 2006

Last updated

Apr 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fort Collins Modern Dentistry, LLP

  dba Fort Collins Modern Dentistry

  • General Practice Dentistry
  • Fort Collins, CO
  • NPI 1013224062
  NPD (past)
• West Newton Dental Associates LLC

  • Dentist
  • West Newton, MA
  • NPI 1588759542
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1437249497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6442 FALCON RIDGE CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259162",
            "telephone_number": "781-799-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 CUSTER DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253684",
            "telephone_number": "970-221-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205298",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21223",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "X10267",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kiehl, LCSW
• Caroline Kilpatrick, MS, RDN
• Elizabeth Marie Kilpatrick
• Helen M Kilzer, MD
• Gina H Kim, M.D.
• Nathan Young Gene Kim, M.D.
• Paige Livingston Kim
• Kimball Endodontics
• Kay Kimball, MHS
• Sue E Kimbell, CFNP

• Dentist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.