Samantha Kim

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22DI03102900 Issued in NJ

Practice address

242 Kearny Ave Ste 2
Kearny, NJ 07032-2505

Phone

(201) 955-2500

NPI assigned

Jun 25, 2025

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

Practice roles

Locations

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

• Kearny Ave Dental Spec LLC

  • Dentist
  • Kearny, NJ
  • NPI 1184361743
  NPD

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1497643969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 OLDWOODS RD",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 KEARNY AVE STE 2",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070322505",
            "telephone_number": "201-955-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI03102900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kearny Volunteer Emergency Rescue Squad
• Kearny Wellness
• Daniel Kellner, PHARM D
• Edward Michael Killilea, M.D.
• Natalia Kim, CCC-SLP
• Mariola K Kufel, LPC
• Priyadarsini Kumarasamy, M.S. CCC- SLP
• Anisha Kuvadia, OT
• Lottie M Kwarteng, LCSW
• David Lac, D.D.S.

• Orthodontics and Dentofacial Orthopedics Dentistry in Kearny, NJ
• Providers in Kearny, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.