Ji Won Kim

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS045637 Issued in PA

Practice address

2361 Bristol Rd
Bensalem, PA 19020-6000

Phone

(215) 752-4514

Fax

(215) 752-5551

NPI assigned

Aug 8, 2023

Reactivated

May 4, 2026

Last updated

May 14, 2026By 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

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1467135574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2361 BRISTOL RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190206000",
            "telephone_number": "215-752-4514",
            "fax_number": "215-752-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2361 BRISTOL RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190206000",
            "telephone_number": "215-752-4514",
            "fax_number": "215-752-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI WON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "deactivation_date": "2024-03-11",
        "reactivation_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS045637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhavi Khant
• Anu Khatri, D.O.
• Bushra Khawar, OD
• Frank Joseph Kieffer Jr., M.S., LPC, NCC
• David S Kim, DMD
• Kindest Care Healthcare LLC
• Lindsey King
• Inna Kiseleva
• Justin Kistler, M.D.
• Marie Klapcuniak

• Orthodontics and Dentofacial Orthopedics Dentistry in Bensalem, PA
• Providers in Bensalem, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.