Eric Duk Ju Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

108259 Issued in CA

Practice address

19637 Turtle Springs Way
Porter Ranch, CA 91326-3834

Phone

(213) 675-5777

NPI assigned

Oct 11, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Eric Dukju Kim DDS, Inc.

  • Dental Clinic/Center
  • Lakewood, CA
  • NPI 1619761871
  NPD Authorized official

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1073238036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19637 TURTLE SPRINGS WAY",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263834",
            "telephone_number": "213-675-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19637 TURTLE SPRINGS WAY",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263834",
            "telephone_number": "213-675-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ERIC",
        "middle_name": "DUK JU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam Khachatryan, MD
• Kevork Alek Khadarian, MD
• Nicholas Anthony Khasho, DO
• Michael Khorramian, D.D.S.
• Kidneycare Dialysis Inc
• Wooshik Kim, PHARMD
• Young Mi Kim, ASW
• Joshua James Kimball, LMFT
• Mkrtich Michael Kirakossian, RPH
• Niramol Kitsawadi, PHARMACIST

• Dentist in Porter Ranch, CA
• Providers in Porter Ranch, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.

Verify at the official NPI Registry.