Kee Nam Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60114393 Issued in WA

Practice address

10303 19TH Ave SE Ste a
Everett, WA 98208-4265

Phone

(425) 357-8384

Fax

(425) 357-8353

NPI assigned

May 27, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1942468004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10303 19TH AVE SE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084265",
            "telephone_number": "425-357-8384",
            "fax_number": "425-357-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10303 19TH AVE SE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084265",
            "telephone_number": "425-357-8384",
            "fax_number": "425-357-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEE",
        "middle_name": "NAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60114393",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Kim, PHARMD
• Helen Kim, DNP
• Inki Kim
• James Inbok Kim, MD
• Jennifer Kim, MD
• Mimi Mi Kim, BA
• Soo Y Kim, MD
• Soohyun Kim, PHARM.D.
• Taehee Kim, MD
• Taeil Kim

• General Practice Dentistry in Everett, WA
• Providers in Everett, 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 Jun 14, 2016; 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.