Active NPI
Lina Kim, DDS
- Dentist
- Seattle, WA
National Provider Identifier
1609955152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00009899
- Practice address
- 4800 Sand Point Way NE
Seattle, WA 98105-3901 - Phone
- (206) 987-7224
- NPI assigned
- Nov 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DE00009899 | WA | Primary |
Addresses
Primary practice location
4800 Sand Point Way NE
Seattle, WA 98105-3901
Mailing address
1518 10TH Ave W
Seattle, WA 98119-3231
Phone (206) 227-1880
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5049366 | Medicaid | WA | |
| N/A | Medicaid | AK | |
| N/A | Medicaid | ID | |
| N/A | Medicaid | MT |
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 |
|---|---|---|---|
| DE00009899 | WA | MD | Dentist |
Interoperability endpoints
- lkim1722@direct.seattlechildrens.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609955152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1518 10TH AVE W",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981193231",
"telephone_number": "206-227-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAND POINT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053901",
"telephone_number": "206-987-7224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "LINA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00009899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5049366",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N/A",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N/A",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N/A",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.