Daniel S Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039701 Issued in PA

Practice address

300 Old Forge LN
Suite 301
Kennett Square, PA 19348-1897

Phone

(610) 388-6789

NPI assigned

Jul 23, 2013

Last updated

Aug 23, 2013By the provider in NPPES

Sex

Male

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 27, 2019 through Mar 27, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1528400264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLD FORGE LN",
            "address_2": "SUITE 301",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481897",
            "telephone_number": "610-388-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD FORGE LN",
            "address_2": "SUITE 301",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481897",
            "telephone_number": "610-388-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennett Square Chiropractic and Rehabilitation, P.C.
• Kennett Square Eye Care LLC
• Kennett Square Family Dentistry, LLC
• Kennett Square Periodontics, PC
• Janice Lawrence Ketcham, MA, CAADC, LPC
• Alissa Kincel
• Kindled Journeys
• Jamie King, PTA
• Brenda Kinsey, COTA
• Jenna Nicole Kirby

• General Practice Dentistry in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.