NPIMap

Individual provider Active NPI

Jong Min Kim, DMD

  • General Practice Dentistry
  • N. Bethesda, MD
National Provider Identifier
1972772564
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13962 Issued in MD
Practice address
5809 Nicholson Lane
Suite#T-123
N. Bethesda, MD 20852
Phone
(301) 770-2270
Fax
(301) 770-2246
NPI assigned
Feb 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13962 MD Primary

Addresses

Primary practice location

5809 Nicholson Lane
Suite#T-123
N. Bethesda, MD 20852

Mailing address

5809 Nicholson Lane
Suite#T-123
N. Bethesda, MD 20852
Phone (301) 770-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1972772564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 NICHOLSON LANE",
            "address_2": "SUITE#T-123",
            "city": "N. BETHESDA",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-770-2270",
            "fax_number": "301-770-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5809 NICHOLSON LANE",
            "address_2": "SUITE#T-123",
            "city": "N. BETHESDA",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-770-2270",
            "fax_number": "301-770-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONG",
        "middle_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N. Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.