Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1417353400 Individual Practitioner Male Practitioner

Dr. Peter J. Kim , DDS

Dentist - General Practice • New Square, NY

Professional Overview & Biography Verified Profile Summary

Dr. Peter Kim, DDS is a registered healthcare professional specializing in Dentist - General Practice in New Square, NY. Practice services are available at 728 N MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

728 N Main St

New Square, NY 109778916

Telephone 8453549300
Associated Practice Facility / Clinic
🏢 Refuah Health Center, Inc. Facility NPI 1003639675

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in New Square, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
4 Specialists

Practicing in New Square, NY (8411 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 058142

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.

Practice Associates & Co-Workers

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

40 Associated Practitioners
NPI 1003104191

Doctor of Medicine (M.D.)

Dr. Ronen Hizami , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1013135516

Doctor of Medicine (M.D.)

Terry Sobler , ORTHODONTIST

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1043350853
NPI 1043905649

Doctor of Dental Surgery

Dr. Navid Vosoughi , DMD

Dentist - Endodontics

NPI 1073830048

Doctor of Dental Medicine

Jennifer Grunhut

Physician Assistant

NPI 1083264253

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location February 21, 2018

Registered at 728 N MAIN ST, NEW SQUARE, NY 109778916 (Tel: 8453549300)

📍
Updated Business Mailing Address February 21, 2018

Registered at 7 STUART CT, HUNTINGTON STATION, NY 117464237 (Tel: 6313554180)

👤
Provider Name / Credentials Updated February 21, 2018

Recorded as PETER KIM, DDS

NPI Profile Active March 11, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location March 11, 2016

Registered at 51 CHARLEYS PL, BAY SHORE, NY 117068066 (Tel: 6313554180)

📍
Updated Business Mailing Address March 11, 2016

Registered at 51 CHARLEYS PL, BAY SHORE, NY 117068066

👤
Provider Name / Credentials Updated March 11, 2016

Recorded as PETER KIM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2016

Dentist (License #058142 in NY)

🟢
Initial NPI Registration & Enumeration November 18, 2014

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: 1417353400
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 18, 2014
Last Update: February 21, 2018
Sole Proprietor: Yes

Mailing Address

7 Stuart Ct

Huntington Station, NY 117464237

Phone: 6313554180

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.