Individual provider Active NPI

Kim Thien DO, DDS

  • Pediatric Dentistry
  • Bremerton, WA
National Provider Identifier
1467990689
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DENT.DE.61022149 Issued in WA
Practice address
1425 NE Franklin Ave
Bremerton, WA 98311-3026
Phone
(360) 377-3844
NPI assigned
Feb 8, 2017
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DENT.DE.61022149 WA Primary

Addresses

Primary practice location

1425 NE Franklin Ave
Bremerton, WA 98311-3026

Mailing address

1425 NE Franklin Ave
Bremerton, WA 98311-3026
Phone (360) 377-3844

Other practice location 1

1931 Pottery Ave
Port Orchard, WA 98366-2512
Phone (360) 377-3844

Other identifiers 1

IdentifierTypeStateIssuer
2157472MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30025260OHMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry for Children LLC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1467990689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 NE FRANKLIN AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113026",
            "telephone_number": "360-377-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 NE FRANKLIN AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113026",
            "telephone_number": "360-377-3844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1931 Pottery Ave",
            "address_purpose": "LOCATION",
            "city": "Port Orchard",
            "state": "WA",
            "postal_code": "983662512",
            "country_code": "US",
            "telephone_number": "360-377-3844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "KIM",
        "middle_name": "THIEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DENT.DE.61022149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2157472",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.