Kieun Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN1859073 Issued in MA

Practice address

1 E Main St
Northborough, MA 01532-1662

Phone

(508) 206-9676

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

No

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

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1750955290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 STADIUM WAY APT 275",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022103",
            "telephone_number": "720-757-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E MAIN ST",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015321662",
            "telephone_number": "508-206-9676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Shrewsbury St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016044648",
            "country_code": "US",
            "telephone_number": "508-319-9974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KIEUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chullainn F Kelly, DC, ATC
• Allison Haley Kenney
• Andreamaria Kick, D.P.T.
• Clara Kim, M.D.
• Daeun Kim
• Kincasa Recovery Centers LLC
• Tracey Colleen King, LICSW
• Mary N Kinyanjui
• Nicole Konarski
• Lara Kopoyan, A.T.

• Dentist in Northborough, MA
• Providers in Northborough, MA by specialty
• Dentist 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.