Kwang Han Kim DDS, PL

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KWANG HAN KIM DDS, PL

Practice address

2071 2ND Ave
New York, NY 10029-4101

Phone

(212) 970-1122

Fax

(212) 970-1105

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Kwang Han Kim, DDS

Title

Owner

Phone

(718) 344-3610

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prime Dental Doing business as

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1972171940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294101",
            "telephone_number": "212-970-1122",
            "fax_number": "212-970-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294101",
            "telephone_number": "212-970-1122",
            "fax_number": "212-970-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANG HAN KIM DDS, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KWANG",
        "authorized_official_middle_name": "HAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-344-3610",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03289865",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon Rose Sarabosing Kwan, P.T.
• Sherry Kwan
• Stephen Kwan
• Tak W. Kwan, MD
• Yee Shun Kwan, LMHC
• Melody Kwang Mabial
• Justice Y Kwansa, PHARMD
• Anita Kwashie, PHD
• Sam Tsung- Ming Kwauk, M.D.
• Kwee Wa LLC

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.