Active NPI
Timothy Kim, DMD
- Dentist
- Hanford, CA
National Provider Identifier
1245725381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 102662
- Practice address
- 1560 W Lacey Blvd Ste 107
Hanford, CA 93230-3587 - Phone
- (559) 772-3415
- NPI assigned
- Jun 29, 2018
- Last updated
- Jun 29, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 102662 | CA | Primary |
Addresses
Primary practice location
1560 W Lacey Blvd Ste 107
Hanford, CA 93230-3587
Mailing address
530 S Main St
Orange, CA 92868-4525
Phone (714) 571-6429
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102662 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530230400000",
"number": "1245725381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684525",
"telephone_number": "714-571-6429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 W LACEY BLVD STE 107",
"city": "HANFORD",
"state": "CA",
"postal_code": "932303587",
"telephone_number": "559-772-3415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TIMOTHY",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-29",
"last_updated": "2018-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "102662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.