Daewonkim DDS, PA

Primary specialty

DentistTaxonomy code 122300000X

License

10839 Issued in MD

Legal business name

DAEWONKIM DDS, PA

Practice address

736 Revolution St
Havre de Grace, MD 21078-3322

Phone

(410) 939-3890

NPI assigned

Jun 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David D Kim, DDSNPI 1356487003

Title

President

Phone

(410) 939-3890

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• David Daewon Kim, DDS

  • General Practice Dentistry
  • Havre de Grace, MD
  • NPI 1356487003
  NPD Authorized official
• Rebecca Garin Dizon, D.D.S.

  • General Practice Dentistry
  • Havre de Grace, MD
  • NPI 1174731673
  NPD (past)
• Alan David Walker, D.D.S.

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1003144346
  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1912100157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783322",
            "telephone_number": "410-939-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783322",
            "telephone_number": "410-939-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAEWONKIM DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-939-3890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "10839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah A Craley, BCBA, LBA
• Megan E. Crawford
• Jessica Creek
• Deborah Crivello, CRNP
• Wanda Denise Currie, MSW, LCSW-C
• Sarah Damaroda
• Emmalee Wey Daniels, PTA
• Christina Lucille Darling, CRNP
• Kristopher Allen Darling
• Harold Darner, RBT

• Dentist in Havre de Grace, MD
• Providers in Havre de Grace, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.