Active NPI
Helen Kim, D.D.S.
- Pediatric Dentistry
- Flushing, NY
National Provider Identifier
1841602745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 057467
- Practice address
- 13107 40TH Rd Ste E30
Flushing, NY 11354-5205 - Phone
- (718) 353-3332
- NPI assigned
- May 27, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 057467 | NY | Primary |
Addresses
Primary practice location
13107 40TH Rd Ste E30
Flushing, NY 11354-5205
Mailing address
13107 40TH Rd Ste E30
Flushing, NY 11354-5205
Phone (718) 353-3332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04680306 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20160920001042 | CT | Order and Referring Only - Dentist | 4789971748 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057467 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493769600000",
"number": "1841602745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13107 40TH RD STE E30",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545205",
"telephone_number": "718-353-3332",
"fax_number": "718-353-7359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13107 40TH RD STE E30",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545205",
"telephone_number": "718-353-3332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HELEN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2017-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "057467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04680306",
"state": "NY"
}
],
"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 May 3, 2017; 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.