Brian Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104004 Issued in TN

Practice address

3030 Covington Pike Ste 150
Memphis, TN 38128-5041

Phone

(901) 310-1441

NPI assigned

Aug 19, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1689007205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 KINGS CROSS LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380165176",
            "telephone_number": "901-830-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285041",
            "telephone_number": "901-310-1441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "442 SW Umatilla Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977567039",
            "country_code": "US",
            "telephone_number": "541-504-3900",
            "fax_number": "541-504-3907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9944",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34666",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "104004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elaine Killian, M.D.
• Jeffrey Killion, LPC-MHSP (TEMP.)
• Corretta Kilpatrick Jones, RN
• Ashley Marie Kilpatrick, RD
• Tyler Kirk Kilpatrick
• Daniel Kim, APRN PMHNP
• Daniel Kim, PHARMD
• Grace Kim, DDS
• Jin-Yon Jeany Kim, MD
• Seunghyun Kim, M.D.

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.