NPIMap

Organization Active NPI

Prime Smile Dental PC

  • Dentist
  • Flushing, NY
National Provider Identifier
1831591049
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8607157 Issued in NY
Legal business name
PRIME SMILE DENTAL PC
Practice address
35-35 149TH Street
Suite 203
Flushing, NY 11354
Phone
(718) 460-9440
NPI assigned
Sep 18, 2014
Last updated
Sep 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Authorized official

Name
Dongkyun Kim, DDSNPI 1932321759
Title
Clinical Director/Owner
Phone
(201) 313-2277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8607157 NY Primary

Addresses

Primary practice location

35-35 149TH Street
Suite 203
Flushing, NY 11354

Mailing address

35-35 149TH Street
Suite 203
Flushing, NY 11354
Phone (718) 460-9440

National Provider Directory

National Provider Directory

Locations

3535 149th St
Ste 203
Flushing, NY 11354
Phone (718) 460-9440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1831591049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35-35 149TH STREET",
            "address_2": "SUITE 203",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-460-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35-35 149TH STREET",
            "address_2": "SUITE 203",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-460-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME SMILE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DONGKYUN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "201-313-2277",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "8607157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.