Organization Active NPI

Young Kim DDS Inc

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1003920059
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31939 Issued in CA
Legal business name
YOUNG KIM DDS INC
Practice address
1721 W Katella Ave #a
Anaheim, CA 92804
Phone
(714) 772-5656
Fax
(714) 772-4434
NPI assigned
Aug 18, 2006
Organization subpart
Yes
Parent organization
YOUNG KIM, DDS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Young Kim, DDS
Title
Dentist/ Owner
Phone
(714) 772-5656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 31939 CA Primary

Addresses

Primary practice location

1721 W Katella Ave #a
Anaheim, CA 92804

Mailing address

1721 W Katella Ave #a
Anaheim, CA 92804
Phone (714) 772-5656

Other identifiers 1

IdentifierTypeStateIssuer
B31939OtherCADENTI-CAL

Other names 1

  • Thank You Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Young Kim Dental Group of Westmoreland Inc

Locations

1721 W Katella Ave
Anaheim, CA 92804
Phone (714) 772-5656

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1003920059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 W KATELLA AVE #A",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-772-5656",
            "fax_number": "714-772-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W KATELLA AVE #A",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-772-5656",
            "fax_number": "714-772-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG KIM DDS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUNG KIM, DDS, INC.",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_title_or_position": "DENTIST/ OWNER",
        "authorized_official_telephone_number": "714-772-5656",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B31939",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thank You Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.