Edwin Gi Lim Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE60685627 Issued in WA

Practice address

1424 Broadway
Everett, WA 98201-1720

Phone

(425) 789-2000

NPI assigned

Mar 2, 2017

Last updated

Nov 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1891235388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 SEATTLE HILL RD APT T5",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980124107",
            "telephone_number": "206-407-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011720",
            "telephone_number": "425-789-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDWIN",
        "middle_name": "GI LIM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-02",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60685627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dae Ho Kim, DDS
• Daniel Byeongheui Kim, MD
• Darran Kim, OD
• David Eugene Kim, DPT
• Duk Soo Kim, DO
• Hanna Kim
• Heather Marie Kim, PHARMD
• Helen Kim, DNP
• Inki Kim
• James Inbok Kim, MD

• Dentist in Everett, WA
• Providers in Everett, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.

Verify at the official NPI Registry.