Dr. Christopher Kim, DDS, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

21561 Issued in TX

Legal business name

DR. CHRISTOPHER KIM, DDS, PA

Doing business as

Eagle Mountain Dentistry

Practice address

8455 Boat Club Rd
Suite 175
Fort Worth, TX 76179-3632

Phone

(817) 750-5433

NPI assigned

May 28, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Chaeho Kim, DDS

Title

Dentist

Phone

(817) 750-5433

Specialties & licenses 1

Addresses

Other names 1

• Eagle Mountain Dentistry Doing business as

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1952748295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 OVERLOOK TER",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762629321",
            "telephone_number": "817-750-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 BOAT CLUB RD",
            "address_2": "SUITE 175",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761793632",
            "telephone_number": "817-750-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CHRISTOPHER KIM, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "CHAEHO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "817-750-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "21561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Mountain Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; 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.