DR. KYUAN KIM (NPI# 1639553795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639553795 |
| Entity Type | Individual |
| Full Name | DR. KYUAN KIM |
| Credential | D.D.S. |
| Practice Address |
15224 Main St Ste 300 Mill Creek WA 98012-7332 |
| Mailing Address |
317 112th Ave Ne Apt 801 Bellevue WA 98004-5824 |
| Practice Telephone | 4253798020 |
| Mailing Telephone | 2179793943 |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2016-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
60698462 | WA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
12012380A | IN | Dental Providers |
| Street Address |
15224 MAIN ST STE 300 |
| City | MILL CREEK |
| State | WA |
| Zip Code | 98012-7332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502032 | Malia Van-frances Chase | Behavioral Analyst | 18311 Bothel-everett Hwy, Suite 260, Bothell, Wa, WA 98012 | 2020-09-14 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1861975526 | Jenifer Rae Denormandie | Pharmacist | 14529 North Creek Drive Apt B210, Mill Creek, WA 98012 | 2018-09-10 |
| 1780161760 | Azadeh Fariba | Naturopath | 15411 40th Dr Se, Bothell, WA 98012 | 2018-07-23 |
| 1720572902 | Rickey Lee Mcgregor | Counselor | 16300 Mill Creek Blvd, Suite 204, Mill Creek, WA 98012 | 2018-06-20 |
| 1306349865 | Rudi Lauren Romaine | Behavioral Analyst | 18311 Bothell-everett Hwy, Suite 260, Bothell, WA 98012 | 2018-03-12 |
| 1164961025 | Wickler Behavioral Consulting | Behavioral Analyst | 632 182nd Street Se, Bothell, WA 98012 | 2017-02-13 |
| 1588026413 | Nathan Earl Crawford | Massage Therapist | 18930 Bothell Everett Hwy, D302, Bothell, WA 98012 | 2016-03-21 |
| 1144618083 | Jocelyn Enabulele | Counselor | 19105 Waxen Road, Bothell, WA 98012 | 2014-12-30 |
| 1124426846 | Teeth R Us | Dentist | 1908 201 Pl Se Suite #201, Bothell, WA 98012 | 2014-12-11 |
| Find all providers in zip 98012 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255768834 | Doug Beck Pllc | Dentist | 1617 183rd St Se Ste 6, Mill Creek, WA 98012-6812 | 2013-09-27 |
| 1629372925 | Gdbeck Pllc | Dentist | 1617 183rd St Se Ste 5, Mill Creek, WA 98012-6812 | 2010-12-29 |
| 1366696114 | Cosmetic & Family Dentistry of Mill Creek | Dentist | 16504 9th Ave Se Ste 103, Mill Creek, WA 98012-6388 | 2008-11-06 |
| 1780847129 | Todd J Berggren | Dentist | 15421 Main St, Ste 101, Mill Creek, WA 98012-9002 | 2008-07-07 |
| 1306041496 | Adam W Berry | Dentist | 1617 183rd St Se, Mill Creek, WA 98012-6812 | 2007-06-18 |
| 1659580249 | Wildwood Dental Group | Dentist | 1617 183rd St Se Ste 1, Mill Creek, WA 98012-6812 | 2007-05-21 |
| 1679796056 | Cason Frederick Culberson | Dentist | 16030 Bothell Everett Hwy Ste 280, Mill Creek, WA 98012-1599 | 2007-04-11 |
| 1720104698 | Roger Allen Flake | Dentist | 13416 Bothell Everett Hwy, Suite 207, Mill Creek, WA 98012-5311 | 2007-03-22 |
| 1447382353 | Thomas C Mccullough | Dentist | 3226 132nd St Sw, Ste 106, Mill Creek, WA 98012 | 2007-03-09 |
| 1437284148 | Family Dental Care of Mill Creek | Dentist | 16030 Bothell Everett Hwy Ste 260, Mill Creek, WA 98012-1274 | 2007-02-22 |
| Find all providers in MILL CREEK | ||||
| City | MILL CREEK |
| Zip Code | 98012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.