Steve Kim D.D.S. Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

57232 Issued in CA

Legal business name

STEVE KIM D.D.S. DENTAL CORPORATION

Practice address

11395 Atlantic Ave
Lynwood, CA 90262-2485

Phone

(909) 282-7776

NPI assigned

Jul 14, 2011

Organization subpart

No

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

Authorized official

Name

Steve Kim, D.D.S.

Title

Ceo

Phone

(909) 282-7776

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313971200000",
    "number": "1215225008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11395 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11395 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622485",
            "telephone_number": "909-282-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE KIM D.D.S. DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-282-7776",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "57232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lynwood, CA
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• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; 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.