NPIMap

Organization Active NPI

Kathleen S. Lim, DDS, P.C.

  • Pediatric Dentistry
  • Tustin, CA
National Provider Identifier
1306436282
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KATHLEEN S. LIM, DDS, P.C.
Practice address
18102 Irvine Blvd Ste 101
Tustin, CA 92780-3423
Phone
(714) 838-9120
Fax
(714) 838-9161
NPI assigned
Jan 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Authorized official

Name
Dr. Kathleen Sun Lim, DDSNPI 1063547933
Title
President/Owner
Phone
(714) 838-9120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

18102 Irvine Blvd Ste 101
Tustin, CA 92780-3423

Mailing address

18102 Irvine Blvd Ste 101
Tustin, CA 92780-3423
Phone (714) 838-9120

Other names 1

  • Tustin Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

18102 Irvine Blvd
Ste 101
Tustin, CA 92780
Phone (714) 838-9120

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1306436282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803423",
            "telephone_number": "714-838-9120",
            "fax_number": "714-838-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803423",
            "telephone_number": "714-838-9120",
            "fax_number": "714-838-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN S. LIM, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "SUN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "714-838-9120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tustin Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.