Dr. Dongwon Kim PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR. DONGWON KIM PC

Practice address

542 River St
Mattapan, MA 02126-3014

Phone

(617) 322-9773

NPI assigned

Aug 12, 2021

Organization subpart

No

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

Authorized official

Name

Dong Won Kim

Title

DMD

Phone

(508) 821-9041

Specialties & licenses 1

Addresses

Tax ID family

Dr Dongwon Kim PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Dongwon Kim PC

  • General Practice Dentistry
  • Taunton, MA
  • NPI 1750523064
  NPD tax ID

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1740955723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021263014",
            "telephone_number": "617-322-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021263014",
            "telephone_number": "617-322-9773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Main St",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "027802736",
            "country_code": "US",
            "telephone_number": "508-821-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. DONGWON KIM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DONG",
        "authorized_official_middle_name": "WON",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "508-821-9041"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hans Desrosiers, NURSE
• Laverne Lydia Dickson, FNP-C
• Jeremiah James Diruzzo, D.C.
• Maria J Dorta
• Leah Louise Dotten
• Althea Lorraine Drew
• El Shaddai Dental Associates Mattapan PC
• Kyesha Chaunte Elliott
• Edith Estrada Juhlin, APRN-BC
• Olasumbo Fadiya, RN

• Dental Clinic/Center in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.