Andrew Kim DDS Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ANDREW KIM DDS INC

Practice address

646 N Larchmont Blvd
Los Angeles, CA 90004-1308

Phone

(323) 464-8677

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Andrew Kim, DDS

Title

Doctor/Authorized Official

Phone

(562) 799-8300

Specialties & licenses 2

Addresses

Other names 1

• ENHANCE DENTAL LARCHMONT Doing business as

Locations

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1083437396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041308",
            "telephone_number": "323-464-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041308",
            "telephone_number": "323-464-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW KIM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "DOCTOR/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "562-799-8300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENHANCE DENTAL LARCHMONT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.