Kim M Ly

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106485 Issued in CA

Practice address

5015 Whittier Blvd
Los Angeles, CA 90022-3116

Phone

(323) 268-9191

NPI assigned

Jul 6, 2021

Sex

Female

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

Specialty

Dentist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1497001226
  Medicare reassignment NPD
• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1235577529
  NPD
• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1467043489
  NPD
• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1730630997
  NPD

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1306417860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S HARVARD BLVD APT 309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900054261",
            "telephone_number": "408-717-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223116",
            "telephone_number": "323-268-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "KIM",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ly
• Julieanne Ly
• Kelvin Ly
• Kevin Ly
• Kieu-Maggie Ly, CASE MANAGER
• Leilani Ly
• Linda Ly
• Linda Thu Ly, OD
• Michelle Ly
• Minh Chuyen Ly

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Jul 6, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.