Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1568081925 Individual Practitioner Female Practitioner

Dr. Eliza Kim , DMD

Dentist - General Practice • Bolingbrook, IL

Professional Overview & Biography Verified Profile Summary

Dr. Eliza Kim, DMD is a registered healthcare professional specializing in Dentist - General Practice in Bolingbrook, IL. Practice services are available at 210 N BOLINGBROOK DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

210 N Bolingbrook Dr

Bolingbrook, IL 604402386

Telephone 6309724010
Associated Practice Facility / Clinic
🏢 Shining Smiles Llc Facility NPI 1972816650

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bolingbrook, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
23 Specialists

Practicing in Bolingbrook, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-08-30
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019033216

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

1 Brookdale Plz

Brooklyn, NY 112123139

Phone: 7182406552

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Milad Nourahmadi , DDS

Dentist - General Practice

NPI 1023240918

Doctor of Dental Surgery

Dr. Nooshin Sanaei , DMD

Dentist - General Practice

NPI 1922738343

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 30, 2021

Registered at 210 N BOLINGBROOK DR, BOLINGBROOK, IL 604402386 (Tel: 6309724010)

📍
Updated Business Mailing Address August 30, 2021

Registered at 210 N BOLINGBROOK DR, BOLINGBROOK, IL 604402386

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 30, 2021

Dentist (License #019033216 in IL)

NPI Profile Active April 15, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location April 15, 2020

Registered at 1 BROOKDALE PLZ, BROOKLYN, NY 112123139 (Tel: 7182406552)

📍
Updated Business Mailing Address April 15, 2020

Registered at 1 BROOKDALE PLZ, BROOKLYN, NY 112123139

👤
Provider Name / Credentials Updated April 15, 2020

Recorded as ELIZA KIM, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 15, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568081925
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 15, 2020
Last Update: August 30, 2021
Sole Proprietor: Yes

Mailing Address

210 N Bolingbrook Dr

Bolingbrook, IL 604402386

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.