Scarlet Kim, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

104759 Issued in CA

Practice address

24481 Alicia Pkwy # 3
Mission Viejo, CA 92691-4534

Phone

(949) 586-9800

NPI assigned

Jul 15, 2016

Last updated

Nov 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hero Dental of Spokane PC

  dba Adventure Dental and Orthodontics

  • General Practice Dentistry
  • Spokane, WA
  • NPI 1598934853
  NPD (past)
• Willamette Dental Group

  • Dentist
  • Salem, OR
  • NPI 1992182026
  NPD (past)

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1033562939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20028 EMERALD MEADOW DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893506",
            "telephone_number": "909-631-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24481 ALICIA PKWY # 3",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926914534",
            "telephone_number": "949-586-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82 E Francis Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992081070",
            "country_code": "US",
            "telephone_number": "509-484-4746",
            "fax_number": "509-484-8281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3490 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973051356",
            "country_code": "US",
            "telephone_number": "503-585-6388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SCARLET",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "00000000",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10635",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "104759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Yoo Kim, PA-C
• Keun-Young Anthony Kim, M.D.
• Lois Sunglim Kim, L.AC
• Minji Kim, FNP-C
• Sarah Soon Kim
• Thomas Benedict Kim, R.N.
• Kimball Orthopedics, Inc.
• Katie Lam Kimpau
• Carrie Ann Kimpton Heald, PHD
• Kinetik Physical Therapy Inc (Kinetik Performance and Rehab)

• Pediatric Dentistry in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.