NPIMap

Organization Active NPI

Kim Jung Stevens Stevens DDS PS

  • General Practice Dentistry
  • Lakewood, WA
National Provider Identifier
1487747580
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3976 Issued in WA
Legal business name
KIM JUNG STEVENS STEVENS DDS PS
Practice address
6001 100TH St SW
Lakewood, WA 98499
Phone
(253) 582-5050
Fax
(253) 582-5399
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Authorized official

Name
Kevin T Kim, DDS
Title
Owner
Phone
(253) 582-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 3976 WA Primary

Addresses

Primary practice location

6001 100TH St SW
Lakewood, WA 98499

Mailing address

6001 100TH St SW
Lakewood, WA 98499
Phone (253) 582-5050

National Provider Directory

National Provider Directory

Locations

6001 100th St SW
Lakewood, WA 98499
Phone (253) 582-5050

Practitioners & affiliated clinicians

Practitioners 4

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1487747580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-582-5050",
            "fax_number": "253-582-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-582-5050",
            "fax_number": "253-582-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM JUNG STEVENS STEVENS DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-582-5050",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "3976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.