John Marion Kim, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

014347 Issued in MI

Practice address

3102 Niles Rd
Saint Joseph, MI 49085-8609

Phone

(269) 429-7122

Fax

(269) 429-6410

NPI assigned

Jun 22, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891731204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858609",
            "telephone_number": "269-429-7122",
            "fax_number": "269-429-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858609",
            "telephone_number": "269-429-7122",
            "fax_number": "269-429-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "middle_name": "MARION",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "014347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2983370",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adil Keskin, MD
• Muhammad Khan, DO
• Mohammed Khatib, DO
• Carol Lynnette Kiel, CCC-SLP
• Johanna Elaine Killian, PA
• Manthan Kimmane-Rathnakar, NP
• Marlinda King, MA
• Susan E Kingbarry, PAC
• David Kipp, MS, PT, OCS
• Joseph Thomas Kirby, PA-C

• Oral and Maxillofacial Surgery (Dentist) in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.