Michael C Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00010055 Issued in WA

Practice address

17500 SE 392ND St
Auburn, WA 98092-9705

Phone

(253) 939-6648

Fax

(253) 887-8737

NPI assigned

Feb 27, 2007

Sex

Male

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 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1447387766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17500 SE 392ND ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980929705",
            "telephone_number": "253-939-6648",
            "fax_number": "253-887-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 SE 392ND ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980929705",
            "telephone_number": "253-939-6648",
            "fax_number": "253-887-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400114",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Agnes Kim, MD
• Che Lim Kim, PHYSICAL THERAPIST
• Danny Song Kim, M.D.
• David Hyuk Kim
• Joanne Kim
• So-Yoon Kim
• Sonia Catherine Kim, SUDP
• Jacqueline Warui Kimani, PMHNP
• Peter Kimani
• Elizaphan Kimuya

• General Practice Dentistry in Auburn, WA
• Providers in Auburn, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.