Kris Kim DDS PLLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

DE60058462 Issued in WA

Legal business name

KRIS KIM DDS PLLC

Practice address

21920 76TH Ave W
Suite 201
Edmonds, WA 98026-7980

Phone

(425) 977-2505

Fax

(425) 977-2506

NPI assigned

Mar 15, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kris Hyemin Kim, DDS, MSDNPI 1134442429

Title

Owner/Dr.

Phone

(425) 977-2505

Specialties & licenses 1

Addresses

Other names 1

• Edmonds Orthodontics Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kris Kim, D.D.S., M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Edmonds, WA
  • NPI 1134442429
  NPD (past) Authorized official
• Paula Ohara, BDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Edmonds, WA
  • NPI 1427523927
  NPD (past)

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1962726281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21920 76TH AVE W",
            "address_2": "SUITE 201",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267980",
            "telephone_number": "425-977-2505",
            "fax_number": "425-977-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21920 76TH AVE W",
            "address_2": "SUITE 201",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267980",
            "telephone_number": "425-977-2505",
            "fax_number": "425-977-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRIS KIM DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "HYEMIN",
        "authorized_official_title_or_position": "OWNER/DR.",
        "authorized_official_telephone_number": "425-977-2505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "DE60058462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edmonds Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mikaela Kozminski
• Matthew Sean Krabbendam, DNP
• Jeanette M Kraemer, LICSW
• Kenneth H Krichman, MD
• Kelcy Kriegel, DPT
• Gurumeenal Krishnan, MD
• Kruger Clinic Orthopaedics, PLLC
• Kruger Clinic Orthopaedics, PLLC
• David K Kuechle, MD
• Melanie K Kuechle, M.D.

• Preferred Provider Organization in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Preferred Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.