Stephanie Kim-Albadawi, D.M.D., M.S.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12014639A Issued in IN

Practice address

13760 Lakeridge Dr
Fishers, IN 46037-7608

Phone

(317) 588-2575

NPI assigned

Jun 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Stephanie Kim Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

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.

• Hoosier Dental in LLC

  • Dental Clinic/Center
  • Indianapolis, IN
  • NPI 1639025638
  NPD (past)
• Hoang and Rho Dental Corporation

  dba Park Place Dental Group

  • General Practice Dentistry
  • Sacramento, CA
  • NPI 1326133190
  NPD (past)
• Rode & Alt Pediatric Dental Partnership

  dba Rocklin Pediatric Dentistry

  • Pediatric Dentistry
  • Rocklin, CA
  • NPI 1386503837
  NPD (past)

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1942615364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 MERCEDES CT",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160280",
            "telephone_number": "661-203-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13760 LAKERIDGE DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377608",
            "telephone_number": "317-588-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4690 Natomas Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958352230",
            "country_code": "US",
            "telephone_number": "916-515-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2221 Sunset Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rocklin",
            "state": "CA",
            "postal_code": "957654784",
            "country_code": "US",
            "telephone_number": "916-435-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4350 Marconi Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958214379",
            "country_code": "US",
            "telephone_number": "916-589-6462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM-ALBADAWI",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12014639A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64762",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "64762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "D.M.D., M.S.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kids Innovative Developmental Services, Inc.
• Kidz R Fun, Inc.
• Janelle E Kieck
• Abby Kiffmeyer, M.A. BCBA
• David Kiley, MD
• Christina Hein Kim, PHARMD
• Christina J Kim, MD
• Miran Kim, FNP-C
• Maggie G Kincade
• Catherine Anne Kinder

• Pediatric Dentistry in Fishers, IN
• Providers in Fishers, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.