Hak Cheon Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36394 Issued in CA

Practice address

2550 S Archibald Ave
#M
Ontario, CA 91761

Phone

(909) 923-6622

Fax

(909) 923-3143

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hak Cheon Kim DDS Inc

  • General Practice Dentistry
  • Ontario, CA
  • NPI 1487720785
  NPD (past) Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407912405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S ARCHIBALD AVE",
            "address_2": "#M",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "909-923-6622",
            "fax_number": "909-923-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 S ARCHIBALD AVE",
            "address_2": "#M",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "909-923-6622",
            "fax_number": "909-923-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAK CHEON",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Kihugu
• Brianna Marie-Fawn Killion
• Anthony Kim, AC
• Dong Won Kim, M.D., PH.D.
• Erica Sarang Kim
• Hannah Kim
• Hyung Kim, DDS
• Jung Jin Kim
• Soyoung Kim
• Ray Dean Kincaid

• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.