Anne Sooyun Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55536 Issued in CA

Practice address

501 Washington St Ste 740
San Diego, CA 92103-2231

Phone

(619) 296-2172

Fax

(619) 296-2178

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• A.S. Kim DDS, Inc.

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1730639188
  NPD Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1275654501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19333 BEAR VALLEY RD",
            "address_2": "SUITE 205",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923085148",
            "telephone_number": "760-247-4155",
            "fax_number": "760-247-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST STE 740",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-296-2172",
            "fax_number": "619-296-2178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19333 Bear Valley Rd",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923085148",
            "country_code": "US",
            "telephone_number": "760-247-4155",
            "fax_number": "760-247-4955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Washington St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032208",
            "country_code": "US",
            "telephone_number": "619-296-6136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANNE",
        "middle_name": "SOOYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275654501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice Kim, PHARM.D
• An Kim, M.D.
• Andrew Kim
• Angela Kim
• Anna S Kim, PHARM.D.
• Annette H Kim, OTR/L
• Austin Chris Leehon Kim, DDS
• Brian Kim, MD
• Bryan Kim
• Bryce D. Kim, M.D.

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.