DR. CHRISTOPHER KIM, DDS, PA (NPI# 1952748295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952748295 |
| Entity Type | Organization |
| Organization Name | DR. CHRISTOPHER KIM, DDS, PA |
| Other Organization Name | EAGLE MOUNTAIN DENTISTRY |
| Practice Address |
8455 Boat Club Rd Suite 175 Fort Worth TX 76179-3632 |
| Mailing Address |
1609 Overlook Ter Keller TX 76262-9321 |
| Practice Telephone | 8177505433 |
| Mailing Telephone | 8177505433 |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |
| Authorized Official Name | DR. CHRISTOPHER CHAEHO KIM (DENTIST) |
| Authorized Official Telephone | 8177505433 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
21561 | TX | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Eagle Mountain Dentistry | Doing Business As Name - Organization |
| Street Address |
8455 BOAT CLUB RD SUITE 175 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76179-3632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992347215 | Katherine M Wright | Behavior Technician | 5804 Boat Club Road, Fort Worth, TX 76179 | 2019-10-09 |
| 1982245775 | Makaylin Rene Mayes | Behavior Technician | 5804 Boat Club Rd, Fort Worth, TX 76179 | 2019-10-02 |
| 1881246049 | Renkuntla Pllc | Dentist | 240 S Saginaw Blvd, Saginaw, TX 76179 | 2019-07-09 |
| 1376062026 | Michele Ann Taylor | Massage Therapist | 6352 Stone Lake Drive, Fort Worth, TX 76179 | 2017-09-13 |
| 1649796921 | Amanda Williams | Music Therapist | 6212 Rocky Point Trail, Lake Worth, TX 76179 | 2017-08-17 |
| 1912437922 | Dentists of Eagle Mountain, PC | Dentist | 4624 West Bailey Boswell Road, Suite 200, Fort Worth, TX 76179 | 2017-06-13 |
| 1982059283 | 11th Hour Counseling | Social Worker | 949 Sherry Ln, Saginaw, TX 76179 | 2016-04-25 |
| 1114307212 | Stephanie Lee Beavers | Chiropractor | 524 Buckstone Dr., Saginaw, TX 76179 | 2015-06-03 |
| 1760885297 | Kali Nagabalaji | Pharmacy | 200 W J Boaz Rd, Ste 100, Saginaw, TX 76179 | 2014-09-29 |
| 1750794541 | Julie Norwood | Dentist | 1453 N. Saginaw Blvd., Suite 150, Saginaw, TX 76179 | 2014-06-09 |
| Find all providers in zip 76179 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750933115 | Smiles of Fort Worth, LLC | Clinic/Center | 5601 Bridge St Ste 480, Fort Worth, TX 76112-2351 | 2019-07-15 |
| 1881156164 | Elizabeth Laborde Dds Pllc | Clinic/Center | 5656 Edwards Ranch Rd, Fort Worth, TX 76109 | 2019-04-04 |
| 1710460688 | Reliable Dentistry Pllc | Clinic/Center | 5228 Sycamore School Road, #108, Fort Worth, TX 76123-7612 | 2018-09-07 |
| 1972001048 | Fort Worth Dental Care Pllc | Clinic/Center | 3646 Granbury Rd # 104, Fort Worth, TX 76109-3717 | 2018-01-24 |
| 1023526365 | J&l Dental Group, Pllc | Clinic/Center | 2401 Heritage Trace Parkway, Suite 121, Fort Worth, TX 76177 | 2018-01-22 |
| 1871002261 | Smile Ninja, Pllc | Clinic/Center | 220 E Seminary Dr Ste 100, Fort Worth, TX 76115-2653 | 2017-09-28 |
| 1538689799 | Mini Joseph Dds Pllc | Clinic/Center | 2977 South Precinct Line Road, Suite 213, Fort Worth, TX 76118-7611 | 2017-06-20 |
| 1578010179 | Mint Dentistry, Pllc | Clinic/Center | 2700 Horne Street, Suite 120, Fort Worth, TX 76107 | 2016-09-01 |
| 1962859884 | Mint Dentistry, Pllc | Clinic/Center | 3829 E Loop 820 S, Fort Worth, TX 76119-4339 | 2016-05-20 |
| 1013382001 | Brown Family Dentistry | Clinic/Center | 4004 White Settlement Rd, Fort Worth, TX 76107-1162 | 2015-12-02 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76179 |
Please comment or provide details below to improve the information on DR. CHRISTOPHER KIM, DDS, PA.
| 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.