Active NPI
Jin Hoon Lim
- General Practice Dentistry
- Fairfield, CA
National Provider Identifier
1285401752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS109672
- Practice address
- 2440 N Texas St
Fairfield, CA 94533-1602 - Phone
- (202) 499-8015
- NPI assigned
- Dec 5, 2023
- Sex
- Male
- 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 | DDS109672 | CA | Primary |
Addresses
Primary practice location
2440 N Texas St
Fairfield, CA 94533-1602
Mailing address
2440 N Texas St
Fairfield, CA 94533-1602
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 |
|---|---|---|---|
| DDS109672 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1285401752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 N TEXAS ST",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 N TEXAS ST",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331602",
"telephone_number": "202-499-8015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "JIN HOON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS109672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.