Angie Y Kim, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

059719-1 Issued in NY

Practice address

13514 Jewel Ave
Flushing, NY 11367-1920

Phone

(718) 997-6453

NPI assigned

Oct 13, 2011

Sex

Female

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

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.

Opted out of Medicare

Yes, effective Oct 28, 2016 through Oct 28, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Helen Weinberg Ortho Group DDS PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Catskill, NY
  • NPI 1194095844
  NPD (past)
• Laser Dentistry for Children LLC

  • Pediatric Dentistry
  • Flushing, NY
  • NPI 1871604371
  NPD (past)
• Buckner Market Place Dental, P.a.

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1023166220

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1942585658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13514 JEWEL AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671920",
            "telephone_number": "718-997-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13514 JEWEL AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671920",
            "telephone_number": "718-997-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANGIE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "32350",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "059719-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Svetlana Kikirov
• Lawrence B Kilo
• Andrew Hyun Kyu Kim, DO
• Andrew S Kim, M.D.
• Angelina Sunghee Kim, MD
• Back Kyun Kim, MD
• Baekbong Kim, MSW
• Bong Song Kim, M.D.
• Bora V Kim, D.O.
• Bryan S Kim, DMD

• Pediatric Dentistry in Flushing, NY
• Providers in Flushing, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.