PRIME DENTAL GROUP, LLC
NPI 1407097850
Dentist - General Practice in Kent, WA

Active since March 16, 2009
302 WASHINGTON AVE S, KENT, WA 98032(253) 520-3866(253) 520-3844 Get Directions Write a Review

NPPES record last updated: October 22, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Prime Dental Group, Llc NPPES

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

PRIME DENTAL GROUP, LLC (NPI 1407097850) is a healthcare organization registered as a general practice in Kent, Washington and active in the NPI registry since March 2009. The organization lists Yongjae Kim, Member, as its authorized official.

NPPES Registry Identity

NPI1407097850
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePRIME DENTAL GROUP, LLC
Location Address302 WASHINGTON AVE SKent, WA 98032-5713
Mailing AddressPo Box 4086Bellevue, WA 98009-4086
Fax(253) 520-3844
Organization SubpartNo
Authorized OfficialYongjae KimMember · (425) 457-3638
Enumeration DateMarch 16, 2009
Last NPPES UpdateOctober 22, 2009
NPI 1407097850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses Licensed in WA · DE00011116 Licensed in WA · DE00011115
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.

302 WASHINGTON AVE S, Kent, WA 98032

Other Identifiers 1

Medicaid5059373WA

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

Dentist
302 WASHINGTON AVE S
KENT, WA 98032
Dentist
302 WASHINGTON AVE S
KENT, WA 98032
Dentist (General Practice)
302 WASHINGTON AVE S
KENT, WA 98032
Dentist
302 WASHINGTON AVE S
KENT, WA 98032
Dentist (General Practice)
302 WASHINGTON AVE S
KENT, WA 98032
Dentist (General Practice)
302 WASHINGTON AVE S
KENT, WA 98032

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407097850, enumerated as an "organization" on March 16, 2009.

The provider is located at 302 WASHINGTON AVE S KENT, WA 98032 and the phone number is (253) 520-3866.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.