Yeun Joo Kim, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

62779 Issued in CA

Practice address

9 Arete Court
Hercules, CA 94547

Phone

(858) 337-5451

NPI assigned

Sep 19, 2013

Last updated

Sep 19, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: yeunjoo.kim@cfei.eclinicaldirectplus.com

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1396171526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ARETE COURT",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "94547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ARETE COURT",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "94547",
            "telephone_number": "858-337-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEUN JOO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joscelyn Carol Jones, ESQ.
• Gatimu Kariithi
• Alma Kaufmann
• Victor C.P. Kerenyi, D.C.
• Farrah Ann Khabagnote, PSYD
• Shanise Madelena King
• Cole Benjamin Knowlden
• Richard James Wei Hsin Ko, PHARMD
• Kevin Koo, MA, BCBA
• Jennifer Krasnoff, MD

• Dentist in Hercules, CA
• Providers in Hercules, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.