Pediatric DentistIndex

Michelle Kim

Pediatric dentist in New York, NY

Registered providerLicense # listed (NC)

Call (212) 305-6100Send a messageMap ↗

Public-record details

Address
622 W 168th St, New York, NY 10032
Phone
(212) 305-6100
Listed under
Individual pediatric dentists
NPI
1114628724
NPI status
Active in the NPPES registry
Provider type
Individual provider
Registered specialty (self-reported taxonomy)
Pediatric Dentistry (1223P0221X)
License number on NPI record
13364 (NC)
NPI first issued
Mar 13, 2023
Years since NPI first issued
3 years (since 2023)
License state on NPI record
NC
NPI record last updated
Jun 30, 2023
Pediatric dentistry listings at this street address
5 (this one included)
Individual pediatric dentists listed at this address
5

NPI 1114628724 is active in the federal NPPES registry (CMS) with Pediatric Dentistry, an ADA-recognized dental specialty, as its self-reported primary taxonomy; license 13364 (NC) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Pediatric Dentist Index does not vet, employ, recommend or guarantee pediatric dental practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Pediatric Dentist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an individual clinician. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Pediatric dentists are dentists who completed an accredited pediatric dentistry residency after dental school. A registered specialty is not board certification. Verify the dental license with the state dental board and board certification with the American Board of Pediatric Dentistry.

View NPI 1114628724 in the official registry ↗

Practices and dentists at this address

Other listings in this directory whose NPI record gives the same street address and ZIP. A shared address usually means a shared practice or building; it does not by itself show who works with whom.

Registered specialty is not board certification. Verify the license with the state dental board and board certification with the American Board of Pediatric Dentistry. Ask which insurance and Medicaid/CHIP plans the practice accepts.

Other pediatric dentistry listings in New York

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