OrganizationActive
Susan Kim DDS
NPI 1265495196 · Pediatric Dentistry · Kirkland, WA
Provider details
- NPI number
- 1265495196
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Susan Kim, President(425) 814-3196
- License
- 9731 (WA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12910 Totem Lake Blvd Ne Ste 103
Kirkland, WA 98034
Phone: (425) 814-3196
Fax: (425) 825-9646
Street-level locationGet directions
Mailing address
12910 Totem Lake Blvd Ne Ste 103
Kirkland, WA 98034-2901
Other names (DBA / former)
- Doing business as
- Evergreen Pediatric Dentistry
- Doing business as
- Evergreen Pediatric Dentistry
Registry dates
- Enumerated
- 2006-04-11
- Last updated
- 2018-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.