KJ Kim Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KJ KIM DENTAL CORP

Doing business as

Ocean Heart Dentistry

Practice address

2952 Oceanside Blvd # 1
Oceanside, CA 92054-4817

Phone

(760) 757-9876

NPI assigned

Sep 29, 2021

Last updated

Sep 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keon Jung Kim, DDSNPI 1831265651

Title

Owner/DDS

Phone

(760) 757-9876

Specialties & licenses 1

Addresses

Other names 1

• OCEAN HEART DENTISTRY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keon Jung Kim, DDS

  • General Practice Dentistry
  • Irvine, CA
  • NPI 1831265651
  NPD Authorized official

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1376215251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2952 OCEANSIDE BLVD # 1",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544817",
            "telephone_number": "760-757-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2952 OCEANSIDE BLVD # 1",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544817",
            "telephone_number": "760-757-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJ KIM DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KEON JUNG",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "760-757-9876",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OCEAN HEART DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marley Kinney
• Kasey Kirchner
• Mario Dewayne Kirk, LPC
• Kirsch Therapy Speech Clinic, Inc. (Kirsch Therapy)
• Samantha L Kissin
• Bret Klausen
• Cynthia Dawn Klein, HAS
• Ashley Nicole Kline, IDC
• Eric John Kloeppel, PSYD
• Frederick Wayne Knapp Jr., D.O.

• Dental Clinic/Center in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.