Michelle K. Kim D.D.S. Corp.

Primary specialty

DentistTaxonomy code 122300000X

License

42670 Issued in CA

Legal business name

MICHELLE K. KIM D.D.S. CORP.

Practice address

2245 E. Colorado Blvd.
Suite 201
Pasadena, CA 91107

Phone

(626) 449-3367

Fax

(626) 449-3376

NPI assigned

Apr 30, 2009

Organization subpart

Yes

Parent organization

MICHELLE K. KIM D.D.S. CORP.As reported in NPPES

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

Authorized official

Name

Mrs. Michelle Kyongah Kim, D.D.S.NPI 1629113857

Title

President/Owner

Phone

(626) 449-3367

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Bright Smile Dental Doing business as

Part of

Michelle K Kim DDS Corp

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Kyongah Kim, DDS

  • Dentist
  • Pasadena, CA
  • NPI 1629113857
  NPD (past) Authorized official
• Hwan Z Suk, M D

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1619902509
  NPD (past)

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1295979532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 E. COLORADO BLVD.",
            "address_2": "SUITE 201",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-449-3367",
            "fax_number": "626-449-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 E. COLORADO BLVD.",
            "address_2": "SUITE 201",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-449-3367",
            "fax_number": "626-449-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE K. KIM D.D.S. CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHELLE K. KIM D.D.S. CORP.",
        "enumeration_date": "2009-04-30",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "KYONGAH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "626-449-3367",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "42670",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "B42670-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Smile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.