Active NPI
Kwang Seob Kim, D.D.S
- General Practice Dentistry
- Rowland Heights, CA
National Provider Identifier
1003035114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 50479
- Practice address
- 18250 Colima Rd
201
Rowland Heights, CA 91748-2602 - Phone
- (626) 964-2875
- Fax
- (626) 964-1033
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 50479 | CA | Primary |
Addresses
Primary practice location
18250 Colima Rd
201
Rowland Heights, CA 91748-2602
Mailing address
4022 Santa Anita LN
Yorba Linda, CA 92886
Phone (909) 319-5777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50479 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kwang S. Kim DDS, Inc | Current | Accepting new patients | |
| Brite Dental Hawaiian Gardens, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Los Angeles, CA
- NPI 1427670603
-
- Dental Clinic/Center
- Hawaiian Gardens, CA
- NPI 1861290074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1003035114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4022 SANTA ANITA LN",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "92886",
"telephone_number": "909-319-5777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18250 COLIMA RD",
"address_2": "201",
"city": "ROWLAND HEIGHTS",
"state": "CA",
"postal_code": "917482602",
"telephone_number": "626-964-2875",
"fax_number": "626-964-1033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KWANG",
"middle_name": "SEOB",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "50479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rowland Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.