Active NPI
Bo Kyoung Kim, DDS
- General Practice Dentistry
- Huntington Park, CA
National Provider Identifier
1285103085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS102979
- Practice address
- 7128 Pacific Blvd Ste B
Huntington Park, CA 90255-4776 - Phone
- (323) 588-0400
- NPI assigned
- Nov 21, 2018
- Last updated
- Dec 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS102979 | CA | Primary |
Addresses
Primary practice location
7128 Pacific Blvd Ste B
Huntington Park, CA 90255-4776
Mailing address
500 S Berendo St Apt 204
Los Angeles, CA 90020-5604
Phone (760) 705-7991
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 |
|---|---|---|---|
| DDS102979 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S.M. Bhatt, DDS, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1285103085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S BERENDO ST APT 204",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900205604",
"telephone_number": "760-705-7991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7128 PACIFIC BLVD STE B",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902554776",
"telephone_number": "323-588-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BO KYOUNG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-21",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS102979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.