Active NPI
Joseph S Kim, D.D.S.
- General Practice Dentistry
- Atwater, CA
National Provider Identifier
1366766685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 59159
- Practice address
- 3605 Hospital Rd
Suite H
Atwater, CA 95301-5173 - Phone
- (415) 669-4416
- NPI assigned
- Mar 15, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 59159 | CA | Primary |
Addresses
Primary practice location
3605 Hospital Rd
Suite H
Atwater, CA 95301-5173
Mailing address
2460 Mission Street
Ste 109
San Francisco, CA 94110-2467
Phone (415) 669-4416
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 |
|---|---|---|---|
| 59159 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1366766685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 MISSION STREET",
"address_2": "STE 109",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102467",
"telephone_number": "415-669-4416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 HOSPITAL RD",
"address_2": "SUITE H",
"city": "ATWATER",
"state": "CA",
"postal_code": "953015173",
"telephone_number": "415-669-4416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOSEPH",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-15",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "59159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atwater, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.