Organization Active NPI

Heivi Kim, DDS, Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1033584669
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63356 Issued in CA
Legal business name
HEIVI KIM, DDS, INC.
Practice address
5877 S Vermont Ave
Los Angeles, CA 90044-3741
Phone
(323) 759-1523
NPI assigned
Dec 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Authorized official

Name
Dr. Heivi Min Ryung Kim, DDS
Title
Owner, DDS
Phone
(213) 718-0811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 63356 CA Primary

Addresses

Primary practice location

5877 S Vermont Ave
Los Angeles, CA 90044-3741

Mailing address

5877 S Vermont Ave
Los Angeles, CA 90044-3741
Phone (213) 718-0811

Other practice location 1

2321 E Florence Ave
Huntington Park, CA 90255-5620
Phone (213) 718-0811

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1033584669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5877 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443741",
            "telephone_number": "213-718-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5877 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443741",
            "telephone_number": "323-759-1523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2321 E Florence Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "902555620",
            "country_code": "US",
            "telephone_number": "213-718-0811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEIVI KIM, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-08",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HEIVI MIN RYUNG",
        "authorized_official_title_or_position": "OWNER, DDS",
        "authorized_official_telephone_number": "213-718-0811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "63356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.