Individual provider Active NPI

Hyun Jung Kim, D.D.S.

  • Dentist
  • Redlands, CA
National Provider Identifier
1235488685
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61845 Issued in CA
Practice address
26630 Barton Rd Apt 2926
Redlands, CA 92373-4332
Phone
(909) 215-1702
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61845 CA Primary

Addresses

Primary practice location

26630 Barton Rd Apt 2926
Redlands, CA 92373-4332

Mailing address

26630 Barton Rd Apt 2926
Redlands, CA 92373-4332
Phone (909) 215-1702

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

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1235488685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26630 BARTON RD APT 2926",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734332",
            "telephone_number": "909-215-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26630 BARTON RD APT 2926",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734332",
            "telephone_number": "909-215-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYUN JUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.