United Dental Fullerton Corp

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

UNITED DENTAL FULLERTON CORP

Practice address

1961 W Malvern Ave Ste G
Fullerton, CA 92833-2177

Phone

(714) 525-6900

NPI assigned

Dec 29, 2011

Organization subpart

No

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

Authorized official

Name

Jeong Hoon Kim

Title

Ceo, Cfo, & Secretary

Phone

(714) 525-6900

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1013286590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1961 W MALVERN AVE STE G",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 W MALVERN AVE STE G",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332177",
            "telephone_number": "714-525-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DENTAL FULLERTON CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JEONG",
        "authorized_official_middle_name": "HOON",
        "authorized_official_title_or_position": "CEO, CFO, & SECRETARY",
        "authorized_official_telephone_number": "714-525-6900"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.