Matthew M Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

14596 Issued in NC

Practice address

621A N Fodale Ave
Southport, NC 28461-3550

Phone

(908) 307-1903

NPI assigned

Jul 4, 2023

Last updated

Jul 10, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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.

• Alamo Ranch 7To7 PLLC

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1760157796
  NPD
• Ortho 7To7 PLLC

  dba 7to7 Dental & Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Antonio, TX
  • NPI 1427930791
  NPD (past)

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1700563434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621A N FODALE AVE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613550",
            "telephone_number": "908-307-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621A N FODALE AVE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613550",
            "telephone_number": "908-307-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-04",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "14596",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Juda, RPH
• Margaret Higgins Kaplan, NP
• Thomas B. Kelso II, MD
• Kerr Drug Inc (Kerr Drug)
• Phillip David Khan, M.D.
• Stephanie Lynn Kirk, LCMHCA
• Eileen Klitsch, PHD
• Maggie Meadows Kornblum, PHARMD
• Jacob Kramell, PT, DPT
• Kimberlee Kreuzer

• Dentist in Southport, NC
• Providers in Southport, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.