NPIMap

Organization Active NPI

Kyuho Lim DMD, PC

  • General Practice Dentistry
  • Cambridge, MA
National Provider Identifier
1821152422
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14326 Issued in MA
Legal business name
KYUHO LIM DMD, PC
Practice address
1 Kendall SQ
Building 300, Suite 312
Cambridge, MA 02139-1562
Phone
(617) 577-8700
Fax
(617) 577-0282
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kyuho Lim, DMDNPI 1255471900
Title
President
Phone
(617) 577-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 14326 MA Primary

Addresses

Primary practice location

1 Kendall SQ
Building 300, Suite 312
Cambridge, MA 02139-1562

Mailing address

1 Briarwood LN
Winchester, MA 01890-3869
Phone (781) 729-1224

Other identifiers 2

IdentifierTypeStateIssuer
X10929KEOtherMABCBS OF MASS
04614OtherMADELTA DENTAL OF MASS

Other names 1

  • Kendall Square Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

1 Kendall Sq
Bldg 300
Cambridge, MA 02139
Phone (617) 577-8700

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821152422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRIARWOOD LN",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018903869",
            "telephone_number": "781-729-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENDALL SQ",
            "address_2": "BUILDING 300, SUITE 312",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391562",
            "telephone_number": "617-577-8700",
            "fax_number": "617-577-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYUHO LIM DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "KYUHO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-577-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MASS",
            "identifier": "X10929KE",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF MASS",
            "identifier": "04614",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kendall Square Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.