Soo-Dong Kim, D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38859 Issued in CA

Legal business name

SOO-DONG KIM, D.D.S., INC.

Practice address

9261 Sierra Ave
Fontana, CA 92335-4710

Phone

(909) 822-2212

Fax

(909) 822-2698

NPI assigned

Jun 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Soo-Dong Kim, D.D.S.

Title

President

Phone

(909) 822-2212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1183161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1194922260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9261 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354710",
            "telephone_number": "909-822-2212",
            "fax_number": "909-822-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9261 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354710",
            "telephone_number": "909-822-2212",
            "fax_number": "909-822-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOO-DONG KIM, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-30",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SOO-DONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-822-2212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Penna Solis, PSYCHIATRIC TECHNICI
• Mayrinor P Soliven, NP
• Briana Somontan
• Chang-Ho Song, MD
• Yiping Song, D.D.S.
• Stacy Soria
• Sorours Dental Office Corporation
• Keturah Mesha Sorrells
• Jasmine Sosa, PHARMD
• Heaven L Soto

• General Practice Dentistry in Fontana, CA
• Providers in Fontana, 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 Sep 12, 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.