Susan J Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20132 Issued in TX

Practice address

1212 W McDermott Dr
Suite 300
Allen, TX 75013-6387

Phone

(972) 359-1300

Fax

(972) 359-1480

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447349733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 W MCDERMOTT DR",
            "address_2": "SUITE 300",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136387",
            "telephone_number": "972-359-1300",
            "fax_number": "972-359-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W MCDERMOTT DR",
            "address_2": "SUITE 300",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136387",
            "telephone_number": "972-359-1300",
            "fax_number": "972-359-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX STATE DENTAL LICENSE",
            "identifier": "20132",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID NUMBER",
            "identifier": "7706223384",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kensei Hosokawa Kim, RPH
• Mary J Kim, LCSW
• Min Jung Kim, D.C.
• Namju Janie Kim
• Robert Kim, D.D.S.
• Sylvia Kim
• Kindercare Health Services LLC
• Kindstead Home Care LLC
• Kinetics and Neuro Consultants of Texas, LLC
• Jessica Elaine King, APRN, NP-C

• General Practice Dentistry in Allen, TX
• Providers in Allen, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.