Andrew Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

53464 Issued in CA

Practice address

2311 Seal Beach Blvd Ste 102
Seal Beach, CA 90740-5623

Phone

(562) 799-8300

Fax

(562) 799-8302

NPI assigned

Apr 4, 2007

Last updated

Sep 26, 2022By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Andrew Kim DDS Inc

  dba Enhance Dental Larchmont

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
  • NPI 1083437396
  Authorized official Same address or phone
• Andrew Kim DDS Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Seal Beach, CA
  • NPI 1841913696
  Authorized official Same address or phone

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1194847939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203563",
            "telephone_number": "562-799-8300",
            "fax_number": "562-799-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 SEAL BEACH BLVD STE 102",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907405623",
            "telephone_number": "562-799-8300",
            "fax_number": "562-799-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lana Kashou
• Shauna Marie Kaufman, RBT, BCBA
• Keith W. Cowhey, DDS, Inc
• Sharon Kelly, PH.D.
• Keystone Pediatric Behavioral Health
• David Kim, PT, DPT
• Hyunmie Lee Kim, NP
• Johnathan Yoon-Young Kim, LVN
• Young Ok Kim
• Gregory R Kimball, M.D.

• Dentist in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.