Samuel Kim DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

51348 Issued in CA

Legal business name

SAMUEL KIM DDS INC

Doing business as

Apple Valley Dental

Practice address

21580 Bear Valley Rd Ste B2-2
Apple Valley, CA 92308-7200

Phone

(760) 247-6007

NPI assigned

Sep 11, 2007

Last updated

Sep 11, 2007By 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

Dr. Samuel Kim, DDSNPI 1609917285

Title

Owner

Phone

(760) 247-6007

Specialties & licenses 1

Addresses

Other names 1

• Apple Valley Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel I Kim, D.D.S.

  • General Practice Dentistry
  • Apple Valley, CA
  • NPI 1609917285
  NPD (past) Authorized official

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1073708202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21580 BEAR VALLEY RD STE B2-2",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923087200",
            "telephone_number": "760-247-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21580 BEAR VALLEY RD STE B2-2",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923087200",
            "telephone_number": "760-247-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL KIM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-247-6007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "51348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apple Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Salisbury, PHN, MSN
• Phyllis Patricia Salkey, ARNP
• Arshad Aziz Samad, PA-C
• Mohammadreza Samadani, M.D.
• Allison Krystine Samp
• San Bernardino County Superintendent of Schools
• San Bernardino County Superintendent of Schools
• Andy Sanchez Coronado
• Andrea Sanchez Mogollon
• Jasmine I Sanchez, PPS

• Dentist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.