Active NPI
Ki M Um, DDS
- Dentist
- Cypress, CA
National Provider Identifier
1114594702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 106224
- Practice address
- 5001 Cerritos Ave Ste a
Cypress, CA 90630-4570 - Phone
- (347) 688-6560
- NPI assigned
- Jun 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 106224 | CA | Primary |
Addresses
Primary practice location
5001 Cerritos Ave Ste a
Cypress, CA 90630-4570
Mailing address
5001 Cerritos Ave Ste a
Cypress, CA 90630-4570
Phone (347) 688-6560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 19, 2022 through Dec 19, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1114594702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5001 CERRITOS AVE STE A",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906304570",
"telephone_number": "347-688-6560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 CERRITOS AVE STE A",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906304570",
"telephone_number": "347-688-6560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UM",
"first_name": "KI",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "106224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.