Active NPI
Angela S Kim, DMD
- Dentist
- Englewood Cliffs, NJ
National Provider Identifier
1487956520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02460200
- Practice address
- 700 E Palisade Ave
Englewood Cliffs, NJ 07632-3058 - Phone
- (917) 674-8778
- Fax
- (201) 470-5789
- NPI assigned
- Nov 22, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02460200 | NJ | Primary |
Addresses
Primary practice location
700 E Palisade Ave
Englewood Cliffs, NJ 07632-3058
Mailing address
22 Somerset Rd
Tenafly, NJ 07670-2524
Phone (917) 674-8778
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02460200 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1487956520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 SOMERSET RD",
"city": "TENAFLY",
"state": "NJ",
"postal_code": "076702524",
"telephone_number": "917-674-8778",
"fax_number": "201-470-5789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 E PALISADE AVE",
"city": "ENGLEWOOD CLIFFS",
"state": "NJ",
"postal_code": "076323058",
"telephone_number": "917-674-8778",
"fax_number": "201-470-5789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ANGELA",
"middle_name": "S",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02460200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood Cliffs, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.