Kelly Kim Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KELLY KIM DENTAL CORPORATION

Doing business as

My Kids Dentist and Orthodontics

Practice address

25100 Hancock Ave Ste 102
Murrieta, CA 92562-5973

Phone

(951) 543-9745

Fax

(951) 543-4178

NPI assigned

Sep 19, 2023

Last updated

Sep 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Kim, DDS

Title

Owner

Phone

(951) 543-9745

Specialties & licenses 1

Addresses

Other names 1

• MY KIDS DENTIST AND ORTHODONTICS Doing business as

Locations

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1063290161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "951-543-9745",
            "fax_number": "951-543-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25100 HANCOCK AVE STE 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625973",
            "telephone_number": "951-543-9745",
            "fax_number": "951-543-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY KIM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-543-9745",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MY KIDS DENTIST AND ORTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kay's Homecare for Seniors LLC
• Rosanna Keast, RN, MSN, FNP-C
• Kathleen A Keays, PA
• Katelyn Kelley, THERAPIST
• Jonathan Geoffrey Kelling, M.D.
• Kelly L McKerahan D O a Professional Medical Corporation
• Thomas Michael Kemmerly, M.D.
• Jason Anthony Kemmett
• Crista Kempisty
• Deborah L Kempston, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.