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Active NPI 1275869000 Individual Practitioner Male Practitioner

Dr. Dae Ho Kim , DDS

Dentist - General Practice • Everett, WA

Professional Overview & Biography Verified Profile Summary

Dr. Dae Ho Kim, DDS is a registered healthcare professional specializing in Dentist - General Practice in Everett, WA. Practice services are available at 5929 EVERGREEN WAY STE 100 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5929 Evergreen Way Ste 100

Everett, WA 982036031

Telephone 4253534469
Fax 4253485216
Associated Practice Facility / Clinic
🏢 Dae Ho Kim Dds Pc Inc Facility NPI 1386053973

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Everett, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
83 Specialists

Practicing in Everett, WA (3345 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: 2026-03-30
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA DE60307878

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License WA DE60307878

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
2071188 (WA)
Medicaid State Provider ID
019027981 (IL)

Secondary Practice Locations

1920 100th St Se Ste C2

Everett, WA 982083832

Phone: 4252490770

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Richard Clark , DDS

Dentist - General Practice

NPI 1376621508

Doctor of Dental Surgery

Dr. Philip Clark , DDS

Dentist - General Practice

NPI 1629040183

Doctor of Dental Surgery

Career & Practice History Timeline

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

8 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2025

Dentist (License #DE60307878 in WA)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 27, 2025

Dentist (License #DE60307878 in WA)

NPI Profile Active October 27, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location October 27, 2014

Registered at 5929 EVERGREEN WAY STE 100, EVERETT, WA 982036031 (Tel: 4253534469)

📍
Updated Business Mailing Address October 27, 2014

Registered at 5929 EVERGREEN WAY STE 100, EVERETT, WA 982036031 (Tel: 4253534469)

👤
Provider Name / Credentials Updated October 27, 2014

Recorded as DAE HO KIM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 27, 2014

Dentist (License #DE60307878 in WA)

🟢
Initial NPI Registration & Enumeration October 29, 2009

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: 1275869000
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 29, 2009
Last Update: March 30, 2026
Sole Proprietor: No

Mailing Address

5929 Evergreen Way Ste 100

Everett, WA 982036031

Phone: 4253534469

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.