Kwang J Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35626 Issued in CA

Practice address

10737 Camino Ruiz
San Diego, CA 92126-2359

Phone

(858) 549-7181

Fax

(858) 549-1490

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ben KJ Kim Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306900683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262363",
            "telephone_number": "858-549-7181",
            "fax_number": "858-549-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262359",
            "telephone_number": "858-549-7181",
            "fax_number": "858-549-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KWANG",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEN",
            "last_name": "KIM",
            "middle_name": "KJ",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katherine J. Kim, M.D.
• Kathleen Kim, M.D.
• Ki-Yoon Kim, M.D.
• Kristin Jenna Kim
• Kristy Kim
• Kye Ok Kim, PHARM. D
• Laura Kim, M.D.
• Leila Broggi Kim, DPT
• Leslie Kim, PHARMD
• Lois Kim, PHARMD.

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 8, 2007; 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.