Active NPI
BJ Kim, DMD
- General Practice Dentistry
- Glendale, AZ
National Provider Identifier
1972992709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE 60511889
- Practice address
- 20000 N 59TH Ave
Glendale, AZ 85308-6868 - Phone
- (206) 323-4233
- NPI assigned
- Jan 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE 60511889 | WA | Primary |
Addresses
Primary practice location
20000 N 59TH Ave
Glendale, AZ 85308-6868
Mailing address
20000 N 59TH Ave
Glendale, AZ 85308-6868
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE 60511889 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493683200000",
"number": "1972992709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20000 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20000 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086868",
"telephone_number": "206-323-4233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BJ",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-16",
"last_updated": "2017-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE 60511889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.