Sang C. Kim, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9494 Issued in WA

Practice address

344 Morris Ave S
Renton, WA 98057-2521

Phone

(425) 255-3576

Fax

(425) 226-6313

NPI assigned

Oct 5, 2006

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1689760415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 MORRIS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572521",
            "telephone_number": "425-255-3576",
            "fax_number": "425-226-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 MORRIS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572521",
            "telephone_number": "425-255-3576",
            "fax_number": "425-226-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANG",
        "middle_name": "C.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercedes Gosnell Kim, CNA, SUDP-T
• Mi Sun Kim, APRN
• Natalie Kim, LMFTA
• Richard Dong Suk Kim, MD
• Sam DK Kim, DMD
• Sang-Mun Kim
• So Hee Kim, ARNP
• Susan Kim, PHARMD
• Tae Yong Kim, CHIROPRACTOR
• Kim'S Chiropractic Clinic Inc

• General Practice Dentistry in Renton, WA
• Providers in Renton, 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 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.