Active NPI
Dennis Kim
- Public Health & General Preventive Medicine Physician
- Mendham, NJ
National Provider Identifier
1538849062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- A63378
- Practice address
- 1 McVickers LN
Mendham, NJ 07945-2936 - Phone
- (310) 722-6953
- NPI assigned
- Jul 19, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | A63378 | CA | Primary |
Addresses
Primary practice location
1 McVickers LN
Mendham, NJ 07945-2936
Mailing address
1 McVickers LN
Mendham, NJ 07945-2936
Phone (310) 722-6953
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 |
|---|---|---|---|
| A63378 | CA | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1538849062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MCVICKERS LN",
"city": "MENDHAM",
"state": "NJ",
"postal_code": "079452936",
"telephone_number": "310-722-6953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MCVICKERS LN",
"city": "MENDHAM",
"state": "NJ",
"postal_code": "079452936",
"telephone_number": "310-722-6953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DENNIS",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "CA",
"license": "A63378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mendham, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.