Kevin Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9921 Issued in WA

Practice address

Kim, Jung, Stevens, Stevens, DDS PS
6001 100TH St SW
Lakewood, WA 98499-2733

Phone

(253) 582-5050

Fax

(253) 276-5956

NPI assigned

Dec 18, 2006

Sex

Male

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

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1790848471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992733",
            "telephone_number": "253-582-5050",
            "fax_number": "253-276-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KIM, JUNG, STEVENS, STEVENS, DDS PS",
            "address_2": "6001 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992733",
            "telephone_number": "253-582-5050",
            "fax_number": "253-276-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jooeun Kim
• Joy Kim, D.D.S
• Jungmi Kim
• Jungmin Judy Kim
• Kathy Kim, O.D.
• Kyong Ho Kim, DO
• Meilani Kim, OT
• Nayeon Kim, FNP
• Sarah Jisun Kim, PHARMD
• Sophia Kim

• General Practice Dentistry in Lakewood, WA
• Providers in Lakewood, 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 May 23, 2018; 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.