Creative Smiles Dental

Primary specialty

DentistTaxonomy code 122300000X

License

48481 Issued in CA

Legal business name

CREATIVE SMILES DENTAL

Practice address

17736 San Bernardino Ave
Fontana, CA 92335-6133

Phone

(909) 822-4363

NPI assigned

Sep 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Yang H Kim, D.D.S.

Title

Owner

Phone

(909) 822-4363

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1083963995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17736 SAN BERNARDINO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356133",
            "telephone_number": "909-822-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17736 SAN BERNARDINO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356133",
            "telephone_number": "909-822-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE SMILES DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YANG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-822-4363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "48481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kent Paul Cramer, DPM
• Judy Cranford
• Richard Craven
• Carol Lynn Crawford, PHARM.D.
• Jeron Crawford
• Philip Cristantiello
• Cassandra Renee Crook
• Lauren Kelly Crostic, PA-C
• Sandra C. Crowder, MD
• Susan J Crowe, NP

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.