Individual provider Active NPI

Christina Kim, DMD

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1124512827
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103190 Issued in CA
Practice address
8285 E Santa Ana Canyon Rd
Anaheim, CA 92808
Phone
(714) 974-5599
NPI assigned
Jun 18, 2018
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 103190 CA Primary

Addresses

Primary practice location

8285 E Santa Ana Canyon Rd
Anaheim, CA 92808

Mailing address

26033 Cape Dr Unit 217
Laguna Niguel, CA 92677-0921
Phone (847) 845-6999

Other practice location 1

20855 Golden Springs Dr Ste 108
Walnut, CA 91789-3800
Phone (909) 598-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103190CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1124512827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26033 CAPE DR UNIT 217",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926770921",
            "telephone_number": "847-845-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8285 E SANTA ANA CANYON RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92808",
            "telephone_number": "714-974-5599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20855 Golden Springs Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Walnut",
            "state": "CA",
            "postal_code": "917893800",
            "country_code": "US",
            "telephone_number": "909-598-1122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.