Individual provider Active NPI

Doil Kim, DDS. MMSC.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
National Provider Identifier
1376703660
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
54534 Issued in CA
Practice address
3663 W 6TH St Ste 207
Los Angeles, CA 90020-3048
Phone
(213) 383-2080
Fax
(213) 383-2082
NPI assigned
Jun 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 9602 MA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 54534 CA Primary

Addresses

Primary practice location

3663 W 6TH St Ste 207
Los Angeles, CA 90020-3048

Mailing address

3663 W 6TH St Ste 207
Los Angeles, CA 90020-3048
Phone (213) 383-2080

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

LicenseStateTypeSpecialty
9602MAMDMental Health Counselor
54534CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Young H. Kim and Doil Kim DDS Inc Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dokim@direct.westerndental.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1376703660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST STE 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203048",
            "telephone_number": "213-383-2080",
            "fax_number": "213-383-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST STE 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203048",
            "telephone_number": "213-383-2080",
            "fax_number": "213-383-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DOIL",
        "name_prefix": "Dr.",
        "credential": "DDS. MMSC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "9602",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "54534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.