Bo Ah Kim, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64452 Issued in CA

Practice address

9850 Genesee Ave Ste 540
La Jolla, CA 92037-1213

Phone

(404) 993-6478

NPI assigned

Apr 29, 2008

Last updated

Apr 11, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1326213463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 540",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371213",
            "telephone_number": "404-993-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 540",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371213",
            "telephone_number": "404-993-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BO",
        "middle_name": "AH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiersten L Riedler MD Corp
• Don O. Kikkawa, M.D.
• Mara Devin Killen, DNP, WHNP
• Alexander J Kim, MD
• Alexander S Kim, M.D.
• Chang Kun Kim, PHARMD
• Debbie Kim, DDS
• Edward J. Kim, P.A.
• Hayden Hyeyeon Kim, PHARMD
• Heeyoung Kim, LCSW

• General Practice Dentistry in La Jolla, CA
• Providers in La Jolla, 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 Apr 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.