NPIMap

Organization Active NPI

S.S. Kim, D.D.S. Inc.

  • General Practice Dentistry
  • Pomona, CA
National Provider Identifier
1386851525
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39026 Issued in CA
Legal business name
S.S. KIM, D.D.S. INC.
Doing business as
GP Dental Center
Practice address
1410 N Garey Ave
Suite B
Pomona, CA 91767-3810
Phone
(909) 623-8535
Fax
(909) 623-8230
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Nina Truong-Kim
Title
Regional Manager
Phone
(951) 377-2278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 39026 CA Primary

Addresses

Primary practice location

1410 N Garey Ave
Suite B
Pomona, CA 91767-3810

Mailing address

1410 N Garey Ave
Suite B
Pomona, CA 91767-3810
Phone (909) 623-8535

Other identifiers 2

IdentifierTypeStateIssuer
B39026-01OtherCADENTICAL
829626OtherCAUNITED CONCORDIA

Other names 1

  • GP Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
GP Dental Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1410 N Garey Ave
Ste B
Pomona, CA 91767
Phone (818) 439-1709

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386851525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 N GAREY AVE",
            "address_2": "SUITE B",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673810",
            "telephone_number": "909-623-8535",
            "fax_number": "909-623-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N GAREY AVE",
            "address_2": "SUITE B",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673810",
            "telephone_number": "909-623-8535",
            "fax_number": "909-623-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.S. KIM, D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRUONG-KIM",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "951-377-2278",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B39026-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "829626",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GP Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.