Kenneth Paul Lim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60459097 Issued in WA

Practice address

3622 Ensign Rd NE Ste D
Olympia, WA 98506-5081

Phone

(360) 570-8016

Fax

(360) 570-8275

NPI assigned

Nov 24, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: klim808752@direct.multicare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alaska Center for Dentistry, PC

  • General Practice Dentistry
  • Wasilla, AK
  • NPI 1770809519
  NPD (past)

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1679801039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 ENSIGN RD NE STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065081",
            "telephone_number": "360-570-8016",
            "fax_number": "360-570-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 ENSIGN RD NE STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065081",
            "telephone_number": "360-570-8016",
            "fax_number": "360-570-8275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 N Main St",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547018",
            "country_code": "US",
            "telephone_number": "907-373-2273",
            "fax_number": "907-373-8456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60459097",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1324",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60459097",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0046",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039082",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberlie Lilley Aggerrson
• Lillie McCatty, LMHC
• Lilly Denture Center, Inc
• Lilly Road Family Dentistry
• Jennah Rae Lilly
• Evan John Lima, PHD
• Lincare Inc.
• Bruce Lincoln, MD
• Kim Cheri Lincoln, O.B.
• Daniel Lindberg

• General Practice Dentistry in Olympia, WA
• Providers in Olympia, 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 Oct 24, 2025; 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.