Individual provider Active NPI

Eugen Kim, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1275035701
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS102224 Issued in CA
Practice address
2032 Marengo St
Los Angeles, CA 90033-1319
Phone
(213) 989-7700
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS102224 CA Primary

Addresses

Primary practice location

2032 Marengo St
Los Angeles, CA 90033-1319

Mailing address

1317 S Westgate Ave Apt 204
Los Angeles, CA 90025-1454
Phone (323) 577-2475

Other practice location 1

123 S Alvarado St
Los Angeles, CA 90057-2201
Phone (213) 989-7700 ext. 2759

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

LicenseStateTypeSpecialty
DDS102224CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1275035701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 S WESTGATE AVE APT 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251454",
            "telephone_number": "323-577-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331319",
            "telephone_number": "213-989-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 S Alvarado St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900572201",
            "country_code": "US",
            "telephone_number": "213-989-7700 x2759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUGEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.