Active NPI
Chris Kwang Kim
- Dental Laboratory
- Plano, TX
National Provider Identifier
1649935099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Laboratory
- License
- 3766
- Practice address
- 2115 Teakwood LN Ste 200
Plano, TX 75075-4425 - Phone
- (657) 331-1046
- NPI assigned
- Nov 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Laboratory | 292200000X | 3766 | TX | Primary |
Addresses
Primary practice location
2115 Teakwood LN Ste 200
Plano, TX 75075-4425
Mailing address
2115 Teakwood LN Ste 200
Plano, TX 75075-4425
Phone (657) 331-1046
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 |
|---|---|---|---|
| 3766 | TX | MD | Dental Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1649935099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 TEAKWOOD LN STE 200",
"city": "PLANO",
"state": "TX",
"postal_code": "750754425",
"telephone_number": "657-331-1046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 TEAKWOOD LN STE 200",
"city": "PLANO",
"state": "TX",
"postal_code": "750754425",
"telephone_number": "657-331-1046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHRIS",
"middle_name": "KWANG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-01",
"last_updated": "2021-11-01",
"certification_date": "2021-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "292200000X",
"taxonomy_group": "",
"desc": "Dental Laboratory",
"state": "TX",
"license": "3766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.