J Kim & M Cervantes-Kim DDS PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

J KIM & M CERVANTES-KIM DDS PLLC

Doing business as

Elliott Bay Dental Burien

Practice address

322 SW 155TH St
Burien, WA 98166-2590

Phone

(206) 243-7811

NPI assigned

Jun 23, 2022

Organization subpart

Yes

Parent organization

J KIM & M CERVANTES-KIM DDS PLLCAs reported in NPPES

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

Authorized official

Name

Misty Cervantes-Kim, DDS

Title

Dentist/Owner

Phone

(209) 406-3057

Specialties & licenses 1

Addresses

Other names 1

• Elliott Bay Dental Burien Doing business as

Part of

J Kim M Cervantes-Kim DDS PLLC

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Misty Ann Cervantes, DDS

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1689750739
  NPD
• Jaimie Kwon

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1851844427
  NPD (past)

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1578294179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 ELLIOTT AVE W STE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981193645",
            "telephone_number": "206-812-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SW 155TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662590",
            "telephone_number": "206-243-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J KIM & M CERVANTES-KIM DDS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J KIM & M CERVANTES-KIM DDS PLLC",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "CERVANTES-KIM",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "209-406-3057",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elliott Bay Dental Burien",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elaine Georgette Irons-Hunt, RN
• Jeanne M Isaacson, MD
• David L. Island, PA-C
• Eileen Iwankiw
• William Iwen, PT
• Fredric Neven Jackson, MD PS
• Jamain Jackson
• Jebryan Armani Jackson
• Tami Jackson, LMT
• Travis Edward Jackson, LMT

• Dental Clinic/Center in Burien, WA
• Providers in Burien, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.