Organization · Type 2 NPI

Susan Kim DDS

Pediatric Dentistry · Kirkland, WA

NPI number 1265495196 Active

Practice location

12910 Totem Lake Blvd NE Ste 103
Kirkland, WA 98034

Fax (425) 825-9646

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	9731 (WA)

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

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NPI record

NPI: 1265495196
Entity type: Organization (Type 2)
Issued: Apr 11, 2006
Last updated: Jul 17, 2018
Status: Active

Other names

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Evergreen Pediatric Dentistry · doing business as
Evergreen Pediatric Dentistry · doing business as

Authorized official

Dr. Susan S Kim, DDS
President
(425) 814-3196

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About NPI 1265495196

Susan Kim DDS's National Provider Identifier is 1265495196, issued on Apr 11, 2006. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Kirkland, WA. The record was last updated on Jul 17, 2018.