NPI Code Detail JSON Logo

1720218910 NPI number — JOHN Y KIM

NPI Number: 1720218910
Health Care Provider/Practitioner: JOHN Y KIM

Information about “1720218910” NPI (JOHN Y KIM) exists in 1720218910 in HTML format HTML  |  1720218910 in plain Text format TXT  |  1720218910 in PDF (Portable Document Format) PDF  |  1720218910 in an XML format XML  formats.

NPI Number : 1720218910 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720218910",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KIM",
    "FirstName": "JOHN",
    "MiddleName": "Y",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KIM",
    "OtherFirstName": "JOHN",
    "OtherMiddleName": "Y",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DMD",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "921 FANSHAWE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHILA",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19111-4801",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-779-6957",
    "MailingAddressFaxNumber": "215-695-0622",
    "FirstLinePracticeLocationAddress": "1936 COTTMAN AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHILA",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19111-3800",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-728-0777",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/22/2009",
    "LastUpdateDate": "07/22/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "DS024115L",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.