Prime Dental, L.L.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3398 Issued in NM

Legal business name

PRIME DENTAL, L.L.C.

Practice address

8611 Golf Course Rd NW
Albuquerque, NM 87114-5775

Phone

(505) 891-6101

NPI assigned

Sep 28, 2010

Last updated

Sep 28, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sun Chun Kim, DDSNPI 1730318684

Title

President

Phone

(404) 610-6816

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Sun Chun Kim, DDS

  • General Practice Dentistry
  • Duluth, GA
  • NPI 1730318684
  NPD (past) Authorized official

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1962711705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 GOLF COURSE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145775",
            "telephone_number": "505-891-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 GOLF COURSE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145775",
            "telephone_number": "505-891-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME DENTAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUN",
        "authorized_official_middle_name": "CHUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-610-6816",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3398",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolene Z Prieto
• Maria A Prieto
• Monica Prieto
• Primary Care and Preventive Services, PC
• Primary Care of Albuquerque LLC
• Prime Growth Consulting LLC
• Prime Solutions RX, LLC
• Prime Therapeutics LLC
• Kellie Ann Primm, OTR/L
• Polly C. Primm, M.D.

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.