NPIMap

Organization Active NPI

HJ Kim DDS, PA

Doing business as Smart Dental

  • General Practice Dentistry
  • Ellicott City, MD
National Provider Identifier
1467783092
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13733 Issued in MD
Legal business name
HJ KIM DDS, PA
Doing business as
Smart Dental
Practice address
9501 Old Annapolis Rd
Ste. 200 a
Ellicott City, MD 21042-6314
Phone
(410) 740-1484
Fax
(410) 740-1486
NPI assigned
Jan 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Authorized official

Name
Dr. Heejung KimNPI 1255455143
Title
Owner
Phone
(410) 740-1484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 13733 MD
Public Health DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223D0001X 13733 MD
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 13733 MD Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X 13733 MD
Dental AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 126800000X

Addresses

Primary practice location

9501 Old Annapolis Rd
Ste. 200 a
Ellicott City, MD 21042-6314

Mailing address

9501 Old Annapolis Rd
Ste. 200 a
Ellicott City, MD 21042-6314
Phone (410) 740-1484

Other identifiers 1

IdentifierTypeStateIssuer
028082800MedicaidMD

Other names 1

  • Smart Dental Doing business as

National Provider Directory

National Provider Directory

Locations

9501 Old Annapolis Rd
Ste 200A
Ellicott City, MD 21042
Phone (410) 740-1484

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1467783092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 OLD ANNAPOLIS RD",
            "address_2": "STE. 200 A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426314",
            "telephone_number": "410-740-1484",
            "fax_number": "410-740-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 OLD ANNAPOLIS RD",
            "address_2": "STE. 200 A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426314",
            "telephone_number": "410-740-1484",
            "fax_number": "410-740-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HJ KIM DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HEEJUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-740-1484",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13733",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "MD",
            "license": "13733",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13733",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "13733",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028082800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smart Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.