Mi Sung Heo-Kim

Primary specialty

DentistTaxonomy code 122300000X

License

50766 Issued in CA

Practice address

5814 Riverside Dr
Chino, CA 91710-4457

Phone

(909) 548-4844

Fax

(909) 548-0774

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mi Sung Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ethel Cruz DMD Inc

  • General Practice Dentistry
  • Chino, CA
  • NPI 1295938447
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1265594881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5814 RIVERSIDE DR",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104457",
            "telephone_number": "909-548-4844",
            "fax_number": "909-548-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5814 RIVERSIDE DR",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104457",
            "telephone_number": "909-548-4844",
            "fax_number": "909-548-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEO-KIM",
        "first_name": "MI SUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MI SUNG",
            "last_name": "KIM",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heman G. Stark Youth Correctional Facility (Heman G. Stark Youth Training School Pharmacy)
• Henry B. Fauni
• Henry Chen M.D. a Professional Corp.
• Hensen and Perlman Ods
• Ronald Alan Hensen, O.D.
• Virginia Hernandez, LCSW
• Herocare LLC (Herocare Medical)
• Alicia S Herrera, RPH
• Nichomi Higgins, LMFT
• Hillside Behavioral Healthcare

• Dentist in Chino, CA
• Providers in Chino, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.