MLK Community Dental & Denture Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MLK COMMUNITY DENTAL & DENTURE CLINIC

Practice address

6044 MLK Jr Way S Ste 101
Seattle, WA 98118-3179

Phone

(206) 708-1179

NPI assigned

Jul 11, 2022

Organization subpart

No

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

Authorized official

Name

Sun Kim

Title

Manager

Phone

(702) 588-1453

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1861126328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6044 MLK JR WAY S STE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183179",
            "telephone_number": "206-708-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6044 MLK JR WAY S STE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183179",
            "telephone_number": "206-708-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLK COMMUNITY DENTAL & DENTURE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-588-1453"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Helena Mo, PHARMD
• Jack S Mo, MD
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• General Practice Dentistry in Seattle, WA
• Providers in Seattle, 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 Jul 11, 2022; 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.