Ji-Hyun Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54163 Issued in CA

Practice address

1404 N Ben Maddox Way
Visalia, CA 93292-2246

Phone

(559) 741-9000

NPI assigned

Jan 10, 2007

Last updated

Aug 12, 2021By the provider in NPPES

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ji Hyun Kim Dental Corp.

  dba Ben Maddox Family Dental

  • General Practice Dentistry
  • Visalia, CA
  • NPI 1174848923
  NPD Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1366592842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4042 W CLINTON ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918401",
            "telephone_number": "559-363-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 N BEN MADDOX WAY",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932922246",
            "telephone_number": "559-741-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI-HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1402304",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "G92150-14",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOVERNMENT STATE PROGRAM",
            "identifier": "G92150-14",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David E Kilgore, MD
• Crystal Minhee Kim, O.D.
• Dean Daehyun Kim, D.D.S.
• Hannah Yejin Kim, MD
• Hayoung Kim, DDS
• Jun Kim, D.O.
• Matthew Kim, M.D.
• Minji Kim, DMD
• Yale Kim
• Joyce W Kimani

• General Practice Dentistry in Visalia, CA
• Providers in Visalia, 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 Aug 12, 2021; 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.