NPIMap

Organization Active NPI

Susan Hae Suk Kim DDS Inc

  • General Practice Dentistry
  • La Habra, CA
National Provider Identifier
1336546514
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61888 Issued in CA
Legal business name
SUSAN HAE SUK KIM DDS INC
Practice address
1301 S Beach Blvd
Unit G
La Habra, CA 90631-6384
Phone
(951) 790-7496
NPI assigned
Dec 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Authorized official

Name
Dr. Hae Suk Kim, D.D.SNPI 1699025270
Title
Dentist/President
Phone
(562) 448-3976

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 61888 CA Primary

Addresses

Primary practice location

1301 S Beach Blvd
Unit G
La Habra, CA 90631-6384

Mailing address

1301 S Beach Blvd
Unit G
La Habra, CA 90631-6384
Phone (562) 448-3976

National Provider Directory

National Provider Directory

Locations

1301 S Beach Blvd
Ste G
La Habra, CA 90631
Phone (562) 448-3976

Practitioners & affiliated clinicians

Practitioners 1

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": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1336546514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S BEACH BLVD",
            "address_2": "UNIT G",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906316384",
            "telephone_number": "562-448-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S BEACH BLVD",
            "address_2": "UNIT G",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906316384",
            "telephone_number": "951-790-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN HAE SUK KIM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HAE SUK",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "562-448-3976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.