Active NPI
Dongho Kim
- Dentist
- Peabody, MA
National Provider Identifier
1821398801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 03253
- Practice address
- 5 Sylvan St
Peabody, MA 01960-1606 - Phone
- (978) 977-7979
- NPI assigned
- Oct 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 03253 | RI | Primary |
| General Practice Dentistry | 1223G0001X | 22247 | MA |
Addresses
Primary practice location
5 Sylvan St
Peabody, MA 01960-1606
Mailing address
5 Sylvan St
Peabody, MA 01960-1606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160420000023 | RI | Order and Referring Only - Dentist | 9537467881 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22247 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786579200000",
"number": "1821398801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 SYLVAN ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019601606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SYLVAN ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019601606",
"telephone_number": "978-977-7979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DONGHO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-25",
"last_updated": "2026-08-13",
"certification_date": "2026-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "RI",
"license": "03253",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "22247",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.