NPIMap

Organization Active NPI

Sue Young Kim DDS a Professional Corporation

  • General Practice Dentistry
  • Santa Ana, CA
National Provider Identifier
1063863017
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50767 Issued in CA
Legal business name
SUE YOUNG KIM DDS A PROFESSIONAL CORPORATION
Practice address
1319 N Main St
Santa Ana, CA 92701-2318
Phone
(714) 972-2782
NPI assigned
Jun 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Authorized official

Name
Sue Young Kim, DDSNPI 1194184804
Title
President
Phone
(213) 700-9627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 50767 CA Primary

Addresses

Primary practice location

1319 N Main St
Santa Ana, CA 92701-2318

Mailing address

6053 E Jack Pine LN
Orange, CA 92869-1542

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": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1063863017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 E JACK PINE LN",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928691542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 N MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012318",
            "telephone_number": "714-972-2782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE YOUNG KIM DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-700-9627",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.