Hae Sook Kim DMD LLC

Primary specialty

DentistTaxonomy code 122300000X

License

13931 Issued in MD

Legal business name

HAE SOOK KIM DMD LLC

Doing business as

Tender Care Dentistry

Practice address

29795 Three Notch Rd
Charlotte Hall, MD 20622-4106

Phone

(301) 290-0001

Fax

(301) 290-5633

NPI assigned

Dec 30, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Hae Sook Kim, DMD

Title

Owner

Phone

(301) 290-0001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tender Care Dentistry Doing business as

Locations

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1538557533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29795 THREE NOTCH RD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206224106",
            "telephone_number": "301-290-0001",
            "fax_number": "301-290-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29795 THREE NOTCH RD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206224106",
            "telephone_number": "301-290-0001",
            "fax_number": "301-290-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAE SOOK KIM DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HAE SOOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-290-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025761300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tender Care Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Brooke Glass, OTR/L
• Lashana Goldsmith
• Jeanine M Grant, ADT
• Joanna Graupman
• Mary Diane Grove, CSC-AD
• Lisa McLeod Hamilton, LAC RN
• Thomas Hao, D.D.S.
• HMR of Maryland LLC
• Jennifer Houck, PTA
• Shelby Jacobs, NP

• Dentist in Charlotte Hall, MD
• Providers in Charlotte Hall, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.