Active NPI
James Hichang Kim, DDS
- General Practice Dentistry
- Anaheim, CA
National Provider Identifier
1043370844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46194
- Practice address
- 1719 W Ball Rd
Anaheim, CA 92804-5502 - Phone
- (714) 776-2190
- Fax
- (714) 776-2191
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46194 | CA | Primary |
Addresses
Primary practice location
1719 W Ball Rd
Anaheim, CA 92804-5502
Mailing address
1719 W Ball Rd
Anaheim, CA 92804-5502
Phone (714) 776-2190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614001379 | CA | Order and Referring Only - Dentist | 6800187352 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46194 | CA | MD | Marriage & Family Therapist |
Interoperability endpoints
- james.kim.p1@direct.cdsdp.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463443200000",
"number": "1043370844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928045502",
"telephone_number": "714-776-2190",
"fax_number": "714-776-2191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928045502",
"telephone_number": "714-776-2190",
"fax_number": "714-776-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAMES",
"middle_name": "HICHANG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2016-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.