Kim Henderson Kids Dentistry PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KIM HENDERSON KIDS DENTISTRY PC

Doing business as

Henderson Kids Dentistry and Orthodontics

Practice address

382 W Lake Mead Pkwy Ste 130
Henderson, NV 89015-7292

Phone

(703) 558-8543

Fax

(702) 673-1119

NPI assigned

May 16, 2023

Organization subpart

No

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

Authorized official

Name

Kyung M King, DDS

Title

Owner

Phone

(702) 558-8543

Specialties & licenses 1

Addresses

Other names 1

• HENDERSON KIDS DENTISTRY AND ORTHODONTICS 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.

• Karissa Handa, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Henderson, NV
  • NPI 1265924096
  NPD

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1568153161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W LAKE MEAD PKWY STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157292",
            "telephone_number": "703-558-8543",
            "fax_number": "702-673-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM HENDERSON KIDS DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KYUNG",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-558-8543",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENDERSON KIDS DENTISTRY AND ORTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Philip Kierl III, DDS
• Patricia Kihara
• Susan Kilburn, RN-C, APN
• Matthew Thomas Killian
• Byron Kilpatrick, MD
• Christina Kim
• Daniel Kim, RPH
• Dong Hyun John Kim, D.O.
• Eddie Jihoon Kim, MD
• Esther Kim, DO

• Dentist in Henderson, NV
• Providers in Henderson, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.

Verify at the official NPI Registry.