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SOUTH BOULEVARD DENTAL
NPI 1053859090
Dentist - General Practice in Charlotte, NC

Active since February 10, 2017
2400 SOUTH BLVD, SUITE 201, CHARLOTTE, NC 28203(980) 819-1817 Get Directions Write a Review

NPPES record last updated: February 10, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Boulevard Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH BOULEVARD DENTAL (NPI 1053859090) is a healthcare organization registered as a general practice in Charlotte, North Carolina and active in the NPI registry since February 2017. The organization lists Sarah Belle Rogers, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1053859090
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameTOMMY L KIM DDS, II, PLLC
Location Address2400 SOUTH BLVD, SUITE 201Charlotte, NC 28203-5159
Mailing Address2400 South Blvd, Suite 201Charlotte, NC 28203-5159 · (980) 819-1817
Phone(980) 819-1817
Organization SubpartNo
Authorized OfficialSarah Belle RogersOffice Manager · (980) 819-1817
Enumeration DateFebruary 10, 2017
✔ NPI 1053859090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NC · NC7145
Definition
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.
2400 SOUTH BLVD, Charlotte, NC 28203
Open in Google Maps ↗

Other Names 1

Doing Business AsSouth Boulevard Dental

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOVANT MEDICAL GROUP, INC.
Obstetrics & Gynecology
2400 SOUTH BLVD, SUITE 103
CHARLOTTE, NC 28203
Mecklenburg County (704) 316-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tommy L Kim Dds, II, PLLC's NPI number?

The NPI number for Tommy L Kim Dds, II, PLLC is 1053859090. It was assigned to this organization in the NPPES registry on February 10, 2017. The provider is doing business as South Boulevard Dental.

Where is Tommy L Kim Dds, II, PLLC located?

Tommy L Kim Dds, II, PLLC is located at 2400 South Blvd Suite 201, Charlotte, NC 28203. The listed phone number is (980) 819-1817.

What is Tommy L Kim Dds, II, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Tommy L Kim Dds, II, PLLC accept?

Health plans from UnitedHealthcare list Tommy L Kim Dds, II, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tommy L Kim Dds, II, PLLC was last updated on February 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.