Sam D.K. Kim, DMD, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60127882 Issued in WA

Legal business name

SAM D.K. KIM, DMD, PLLC

Practice address

1412 SW 43Rd St Ste 109
Renton, WA 98057-4803

Phone

(425) 999-1281

NPI assigned

Sep 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dong Kyung Kim, DMD

Title

Owner

Phone

(425) 999-1281

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1619250016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST STE 109",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "425-999-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST STE 109",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "425-999-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM D.K. KIM, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DONG KYUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-999-1281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60127882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Renton, WA
• Providers in Renton, 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 Sep 21, 2011; 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.