Ji Young Kim-Aun, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE9609 Issued in WA

Practice address

2607 Bridgeport Way W
Suite 1K
University Place, WA 98466-4700

Phone

(253) 564-2701

Fax

(253) 566-3638

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619021631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 BRIDGEPORT WAY W",
            "address_2": "SUITE 1K",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664700",
            "telephone_number": "253-564-2701",
            "fax_number": "253-566-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 BRIDGEPORT WAY W",
            "address_2": "SUITE 1K",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664700",
            "telephone_number": "253-564-2701",
            "fax_number": "253-566-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-AUN",
        "first_name": "JI",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE9609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Elizabeth Kelley, MA
• Virginia Kelly, M.A., CCC-SLP
• Claire Kilbourne
• Thomas Millar Killen, PHARMD
• Kim Aun DDS PS
• Prasith Kim-Aun, DMD
• Ahlia Rae Kim, LMFT
• Dae Ok Kim
• Donna Kim, MS, RD
• Jonathan J Kim, RN

• General Practice Dentistry in University Place, WA
• Providers in University Place, WA by specialty
• General Practice Dentistry in Washington

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.