Active NPI
Eunice Y Im, DDS
- Pediatric Dentistry
- Arcadia, CA
National Provider Identifier
1013120468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 47911
- Practice address
- 715 S 1St Ave
Suite D
Arcadia, CA 91006-7525 - Phone
- (626) 445-8600
- Fax
- (626) 445-8601
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 47911 | CA | Primary |
Addresses
Primary practice location
715 S 1St Ave
Suite D
Arcadia, CA 91006-7525
Mailing address
6161 Temple City Blvd
Temple City, CA 91780-1748
Phone (626) 445-8600
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47911 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eunice Y. Im, D.D.S., Inc. | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1013120468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6161 TEMPLE CITY BLVD",
"city": "TEMPLE CITY",
"state": "CA",
"postal_code": "917801748",
"telephone_number": "626-445-8600",
"fax_number": "626-445-8601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 S 1ST AVE",
"address_2": "SUITE D",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910067525",
"telephone_number": "626-445-8600",
"fax_number": "626-445-8601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IM",
"first_name": "EUNICE",
"middle_name": "Y",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "47911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.