Yongjae Kim, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE00011116 Issued in WA

Legal business name

YONGJAE KIM, DDS, PLLC

Doing business as

Lynnwood Prime Dental Group

Practice address

3333 184TH St SW
Suite #U
Lynnwood, WA 98037-4724

Phone

(425) 251-0707

NPI assigned

Jun 20, 2009

Last updated

Dec 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yongjae Kim, DDSNPI 1639108152

Title

Member

Phone

(425) 457-3638

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Lynnwood Prime Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yongjae Kim, DDS

  • General Practice Dentistry
  • Lynnwood, WA
  • NPI 1639108152
  NPD (past) Authorized official

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

{
    "created_epoch": "1245456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1558598268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4086",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980094086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 184TH ST SW",
            "address_2": "SUITE #U",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374724",
            "telephone_number": "425-251-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONGJAE KIM, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-20",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YONGJAE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "425-457-3638",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011115",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5060132",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynnwood Prime Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Okran Yi
• Seong Il Yi
• Jungbin Jay Yim, L.D.O.
• Sangmi Yim
• Seojin Yim, L.AC.
• Mykayla Ann Yonkoske
• Jaeho Yoon, L.AC.
• Jung Hoon Yoon
• Morgan Catherine Yopp
• Tracey Lee Yost, LMP

• Dentist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.