DJ Dental Group, Kim & Kim Professional Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54775 Issued in CA

Legal business name

DJ DENTAL GROUP, KIM & KIM PROFESSIONAL CORP

Practice address

4887 La Palma Ave
La Palma, CA 90623-2019

Phone

(714) 778-6614

Fax

(562) 402-6377

NPI assigned

Mar 13, 2013

Last updated

Mar 13, 2013By 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. Joowon Kim, D.D.S.

Title

President

Phone

(714) 778-6614

Specialties & licenses 2

Addresses

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.

• Kyu Soo Kang, DDS

  • Dentist
  • La Palma, CA
  • NPI 1376758847
  NPD (past)

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1073854139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232019",
            "telephone_number": "714-778-6614",
            "fax_number": "562-402-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232019",
            "telephone_number": "714-778-6614",
            "fax_number": "562-402-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJ DENTAL GROUP, KIM & KIM PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOOWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-778-6614",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54775",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Diaz-Ambriz, LMFT
• Denise Diaz
• Monica Diaz
• Phatimah Didomenico
• Nam Khoa Dinh
• Tony Duc DO, DO
• Mayur Domadia, PHARMD
• Michael Dominic, M.A.
• Rachelle Jeannea Douglass, MD
• Tarrie J Dozier

• General Practice Dentistry in La Palma, CA
• Providers in La Palma, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.