Yoo Jin Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51093 Issued in CA

Practice address

15301 Washington Ave
San Leandro, CA 94579-1811

Phone

(510) 351-6820

NPI assigned

Dec 29, 2005

Last updated

Dec 5, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1093792194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11478 SILVERGATE DR",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682753",
            "telephone_number": "925-833-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 WASHINGTON AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945791811",
            "telephone_number": "510-351-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOO",
        "middle_name": "JIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51093",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiyoon Kim
• Jorge Kim, MD
• Julie Ji Kim, LCSW
• Myong H Kim
• Soomi Kim
• Nadia Kimbell
• Mira Kinebuchi
• Alexis King, MFT
• Alyssa T King
• Tierra King

• General Practice Dentistry in San Leandro, CA
• Providers in San Leandro, 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 Dec 5, 2011; 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.