Active NPI
Yongjae Kim, DDS
- General Practice Dentistry
- Lynnwood, WA
National Provider Identifier
1639108152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00011116
- Practice address
- 3333 184TH St SW Ste U
Lynnwood, WA 98037-4742 - Phone
- (425) 251-0707
- Fax
- (425) 608-5642
- NPI assigned
- Jun 30, 2006
- Last updated
- Jan 9, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS035432 | PA | |
| General Practice Dentistry | 1223G0001X | DE00011116 | WA | Primary |
Addresses
Primary practice location
3333 184TH St SW Ste U
Lynnwood, WA 98037-4742
Mailing address
PO Box 4086
Bellevue, WA 98009-4086
Phone (425) 251-0707
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 |
|---|---|---|---|
| DS035432 | PA | MD | General Practice Dentistry |
| DE00011116 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yongjae Kim, DDS, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767916800000",
"number": "1639108152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4086",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980094086",
"telephone_number": "425-251-0707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 184TH ST SW STE U",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980374742",
"telephone_number": "425-251-0707",
"fax_number": "425-608-5642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YONGJAE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2026-01-09",
"certification_date": "2026-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS035432",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00011116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.