Active NPI
Jangsook Kim, D.D.S.
- General Practice Dentistry
- Valencia, CA
National Provider Identifier
1336275338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46276
- Practice address
- 23501 Cinema Dr. #114
Valencia, CA 91355 - Phone
- (661) 253-3030
- Fax
- (661) 253-3468
- NPI assigned
- Feb 26, 2007
- Last updated
- Nov 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46276 | CA | Primary |
Addresses
Primary practice location
23501 Cinema Dr. #114
Valencia, CA 91355
Mailing address
23501 Cinema Dr. #114
Valencia, CA 91355-1818
Phone (661) 253-3030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46276 | CA | MD | Critical Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alhayat Dental Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478044800000",
"number": "1336275338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23501 CINEMA DR. #114",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913551818",
"telephone_number": "661-253-3030",
"fax_number": "661-253-3468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23501 CINEMA DR. #114",
"city": "VALENCIA",
"state": "CA",
"postal_code": "91355",
"telephone_number": "661-253-3030",
"fax_number": "661-253-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JANGSOOK",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2016-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.