Nicholas S Kim, DMD MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN1859729 Issued in MA

Practice address

180 Elsbree St
Fall River, MA 02720-7212

Phone

(508) 672-1069

NPI assigned

Oct 28, 2019

Last updated

Mar 20, 2024By the provider in NPPES

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1457994980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ELSBREE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027207212",
            "telephone_number": "508-672-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ELSBREE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027207212",
            "telephone_number": "508-672-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "NICHOLAS",
        "middle_name": "S",
        "credential": "DMD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1859729",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "1016683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Wall Kiley
• Kenneth Richard Kiley Jr., M.S. R.PH
• Abigail Killeen
• Jennifer Townsend Killenberg, M.S.W.
• Kevin Patrick Kilroy, D.D.S.
• Benjamin Joel Kimball, B.A.
• Kimwell Healthcare LLC (Kimwell)
• Kimwell Nursing SNF Operations BHC
• Kimwell Operating LLC
• Kimwell SNF Opco LLC (Kimwell Nursing Health Care Center)

• Oral and Maxillofacial Surgery (Dentist) in Fall River, MA
• Providers in Fall River, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.