Min-Jeong Kim, DDS, Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

53004 Issued in CA

Legal business name

MIN-JEONG KIM, DDS, INC

Practice address

20700 Lake Chabot Road
Suite 205
Castrol Valley, CA 94546

Phone

(510) 538-2098

NPI assigned

May 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Min-Jeong Kim, DDS, MS

Title

President

Phone

(415) 244-1722

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Niekia Monic Franklin, D.D.S.

  • Pediatric Dentistry
  • Castro Valley, CA
  • NPI 1437530177
  NPD (past)
• Shervin K Yazdi IX, D.D.S.

  • Pediatric Dentistry
  • Castro Valley, CA
  • NPI 1376697524
  NPD (past)

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1356576532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 FOREST VIEW DR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94132",
            "telephone_number": "415-244-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20700 LAKE CHABOT ROAD",
            "address_2": "SUITE 205",
            "city": "CASTROL VALLEY",
            "state": "CA",
            "postal_code": "94546",
            "telephone_number": "510-538-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIN-JEONG KIM, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MIN-JEONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-244-1722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "53004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; 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.