Douglas William Kim, DMD, MS
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Closter, NJ
NPI 1962856070 · NPPES record last updated Nov 19, 2021
Key facts
- NPI
- 1962856070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 22DI02768300 (NJ)
- Practice address
- 570 Piermont Rd Ste C1
Closter, NJ 07624-3100 - Phone
- (201) 666-2828
- NPI assigned
- Apr 15, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02768300 | NJ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Closter Dental PC | Current |
Accepting new patients | |
| Douglas Kim DMD PC | Orthodontics and Dentofacial Orthopedics | Current |
Accepting new patients |
Locations
570 Piermont Rd
Ste C1
Closter, NJ 07624
Phone (201) 245-4362
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 22DI02768300 | NJ | Yes |
Addresses
Primary practice location
570 Piermont Rd Ste C1
Closter, NJ 07624-3100
Mailing address
PO Box 663
Alpine, NJ 07620-0663
Phone (201) 245-4362
Other providers in Closter, NJ
- Jy Moon Acupuncture Wellness and Herbs PC
- Paul Kelly
- Mina Khalil
- Annette Kherlopian
- Byungtae Henry Kim
- Jennifer Kim
- Jinwan Kim
- Jun S Kim
- Jung Young Kim
- Sung Rae Kim
All providers in Closter, NJ · Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.