Susan Ji Hyun Kim, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

48731 Issued in CA

Practice address

11998 Foothill Blvd.
Lake View Terrace, CA 91342-7101

Phone

(818) 897-5055

Fax

(818) 897-0218

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Susan J. Kim, D.D.S., Inc

  dba Lakeview Family Dental

  • Dentist
  • Lake View Terrace, CA
  • NPI 1285836635
  Authorized official Same address or phone

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184799702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11998 FOOTHILL BLVD.",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913427101",
            "telephone_number": "818-897-5055",
            "fax_number": "818-897-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11998 FOOTHILL BLVD.",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913427101",
            "telephone_number": "818-897-5055",
            "fax_number": "818-897-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUSAN",
        "middle_name": "JI HYUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikesha M Johnson, LVN
• Eddeta Jones, LVN
• Robert Manuel Jones, M.M., LMFT
• Joi Jumaoas
• Elie Kapuya
• Rachel Onyu Kwon, LMFT
• Brian Joon Hoon Lee
• Eunice Lee, M.S.
• Steven Mark Levitt, SUBSTANCE ABUSE COUN
• Mikayla Marie Lewis-Campbell

• Dentist in Lake View Terrace, CA
• Providers in Lake View Terrace, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.