Joe Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE8720 Issued in WA

Practice address

14823 SE 79TH PL
Newcastle, WA 98059-9226

Phone

(206) 816-4941

NPI assigned

Mar 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Evergreen Family Dental, Mill Creek, Inc

  • General Practice Dentistry
  • Mill Creek, WA
  • NPI 1396601688
  NPD

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669506135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14823 SE 79TH PL",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980599226",
            "telephone_number": "206-816-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14823 SE 79TH PL",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980599226",
            "telephone_number": "206-816-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE8720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Jensen, LMP
• Jillian Yoshimoto DO PLLC
• Amit Joshi, MD
• Shea Judd-Hume
• Kaplan Medical, PLLC (Rejuve Medspa)
• Yoo-Jung Karen Kim, PHARM. D
• Courtney King, LMP
• Kathleen Maura Koenig, PT
• Victoria Kolbel
• Krista Kowalchik

• Dentist in Newcastle, WA
• Providers in Newcastle, WA by specialty
• Dentist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.