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SAM DK KIM DMD
NPI 1528348695
Dentist - General Practice in Renton, WA

Active since August 22, 2011PECOS Enrolled
1412 SW 43RD ST, IDC MEDICAL PLAZA, #109, RENTON, WA 98057(253) 277-8767(253) 277-8769 Get Directions Write a Review

NPPES record last updated: January 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sam Dk Kim Dmd NPPES

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

SAM DK KIM DMD (NPI 1528348695) is an individual general practice provider in Renton, Washington, licensed in Washington (DE60127882) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528348695
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameSAM DK KIMCredential: DMD
Location Address1412 SW 43RD ST, IDC MEDICAL PLAZA, #109Renton, WA 98057-4803
Mailing Address1412 Sw 43rd St Ste 109Renton, WA 98057-4803 · (253) 277-8767 · Fax (253) 277-8769
Phone(253) 277-8767
Fax(253) 277-8769
Sole ProprietorYes
Enumeration DateAugust 22, 2011
Last NPPES UpdateJanuary 4, 2019
✔ NPI 1528348695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WA · DE60127882
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.
1412 SW 43RD ST, Renton, WA 98057
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sam Dk Kim Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98057 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MR. TIMOTHY STEWART MACP, MDIV, LMHCA
Counselor (Mental Health)
1412 SW 43RD ST, SUITE 111
RENTON, WA 98057
King County (425) 496-4411
GABREIL SANTANA
Technician
1412 SW 43RD ST
RENTON, WA 98057
King County (206) 971-8830
AWA TOURAY
Student in an Organized Health Care Education/Training Program
1412 SW 43RD ST
RENTON, WA 98057
King County (646) 474-1822
EVELYN SPIEKER MN, ARNP
Nurse Practitioner (Women's Health)
1412 SW 43RD ST, SUITE 200
RENTON, WA 98057
King County (425) 271-4910
MR. JAMISON R RIDGELEY MD
Ophthalmology
1412 SW 43RD ST, SUITE 206
RENTON, WA 98057
King County (253) 236-5720
PACIFIC RETINA CENTER PLLC
Ophthalmology (Retina Specialist)
1412 SW 43RD ST
RENTON, WA 98057
King County (910) 742-7427
PAVILLE V. CASTILLO
Counselor
1412 SW 43RD ST
RENTON, WA 98057
King County (425) 264-0750
ASSOCIATED VALLEY COUNSELING, LLC
Counselor (Mental Health)
1412 SW 43RD ST, SUITE 111
RENTON, WA 98057
King County (206) 229-5025

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 Sam Kim's NPI number?

The NPI number for Sam Kim is 1528348695. It was assigned to this individual provider in the NPPES registry on August 22, 2011.

Where is Sam Kim located?

Sam Kim practices at 1412 SW 43rd St Idc Medical Plaza, #109, Renton, WA 98057. The listed phone number is (253) 277-8767.

What is Sam Kim's specialty?

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

Is Sam Kim enrolled in Medicare?

Yes. Sam Kim is registered in the Medicare PECOS enrollment system.

What insurance does Sam Kim accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Renaissance Dental and UnitedHealthcare list Sam Kim 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 Sam Kim was last updated on January 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.