Individual provider Active NPI

Julie Yongsook Kim, D.D.S

  • General Practice Dentistry
  • Buena Park, CA
National Provider Identifier
1386971000
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58033 Issued in CA
Practice address
7841 Commonwealth Ave
Buena Park, CA 90621-2422
Phone
(714) 739-7173
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58033 CA Primary

Addresses

Primary practice location

7841 Commonwealth Ave
Buena Park, CA 90621-2422

Mailing address

2882 Muir Trail Dr
Fullerton, CA 92833-5516
Phone (562) 505-6301

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

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1386971000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 MUIR TRAIL DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928335516",
            "telephone_number": "562-505-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7841 COMMONWEALTH AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212422",
            "telephone_number": "714-739-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JULIE",
        "middle_name": "YONGSOOK",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.