William Woo Kyeom Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

106527 Issued in CA

Practice address

82151 Avenue 42 Ste 110
Indio, CA 92203-9313

Phone

(176) 025-5759

NPI assigned

Jul 9, 2021

Last updated

Jul 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• William Kim DDS Inc

  dba Redefine Dentistry

  • Dental Clinic/Center
  • Artesia, CA
  • NPI 1164146486
  NPD Authorized official

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1285206227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 SUNSET PL",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654558",
            "telephone_number": "909-525-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82151 AVENUE 42 STE 110",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922039313",
            "telephone_number": "176-025-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WILLIAM",
        "middle_name": "WOO KYEOM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Kim
• Evelyn Sungmin Kim, PHARMD
• Hyun Il Kim
• Jessica Jeehyun Kim
• Jonathan Kim, DPM
• Leo J King, PT
• Theodora King, MFT INTERN
• Nicole Kippel, ACSW
• Amber Kirby
• Karl David Kirsch

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.