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DR. ELLY BUNSUN KIM D.D.S.
NPI 1104174168
Dentist - General Practice in Albuquerque, NM

Active since August 24, 2012
4201 CENTRAL AVE NW, ALBUQUERQUE, NM 87105(505) 843-7172 Get Directions Write a Review

NPPES record last updated: August 24, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Elly Bunsun Kim D.d.s. NPPES

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

DR. ELLY BUNSUN KIM D.D.S. (NPI 1104174168) is an individual general practice provider in Albuquerque, New Mexico, licensed in New Mexico (DD3755) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1104174168
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ELLY BUNSUN KIMCredential: D.D.S.
Location Address4201 CENTRAL AVE NWAlbuquerque, NM 87105-1630
Mailing Address4201 Central Ave NwAlbuquerque, NM 87105-1630
Phone(505) 843-7172
Sole ProprietorNo
Enumeration DateAugust 24, 2012
✔ NPI 1104174168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NM · DD3755
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.
4201 CENTRAL AVE NW, Albuquerque, NM 87105
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Other Providers at the Same Location NPPES 8

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

RENAL AND INTERNAL MEDICINE CONSULTANT PC
Internal Medicine (Nephrology)
4201 CENTRAL AVE NW, SUITE K-2
ALBUQUERQUE, NM 87105
Bernalillo County (505) 639-5438
JULIANNE AUSTIN A.R.N.P.
Nurse Practitioner (Family)
4201 CENTRAL AVE NW, SUITE K2
ALBUQUERQUE, NM 87105
Bernalillo County (505) 503-7250
FAMILY SMILES, LLC
Dentist (General Practice)
4201 CENTRAL AVE NW, F-1
ALBUQUERQUE, NM 87105
Bernalillo County (505) 843-7172
MILAGRO PHYSICAL THERAPY, LLC
Physical Therapist
4201 CENTRAL AVE NW, SUITE K-2
ALBUQUERQUE, NM 87105
Bernalillo County (505) 429-2686
OMNI MEDICAL GROUP LLC
Clinic/Center
4201 CENTRAL AVE NW, K3
ALBUQUERQUE, NM 87105
Bernalillo County (505) 717-1685
TURQUOISE MESA LLC
Nurse Practitioner (Family)
4201 CENTRAL AVE NW, SUITE K-2
ALBUQUERQUE, NM 87105
Bernalillo County (505) 503-7250
CADE CLINICAL CONSULTING LLC
Nurse Practitioner (Family)
4201 CENTRAL AVE NW, SUITE K-2
ALBUQUERQUE, NM 87105
Bernalillo County (505) 503-7250
RAMON ROSA DUARTE MD
Internal Medicine (Nephrology)
4201 CENTRAL AVE NW, SUITE K-2
ALBUQUERQUE, NM 87105
Bernalillo County (505) 639-5438

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 Elly Kim's NPI number?

The NPI number for Elly Kim is 1104174168. It was assigned to this individual provider in the NPPES registry on August 24, 2012.

Where is Elly Kim located?

Elly Kim practices at 4201 Central Ave NW, Albuquerque, NM 87105. The listed phone number is (505) 843-7172.

What is Elly Kim's specialty?

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

When was this NPI record last updated?

The NPPES record for Elly Kim was last updated on August 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.