Individual provider Active NPI

Young One Kim, D.D.S.

  • Dentist
  • Van Nuys, CA
National Provider Identifier
1417157884
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50623 Issued in CA
Practice address
7301 Sepulveda Blvd
#4
Van Nuys, CA 91405-1782
Phone
(818) 997-0315
Fax
(818) 997-0316
NPI assigned
Jul 23, 2007
Last updated
Jul 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50623 CA Primary

Addresses

Primary practice location

7301 Sepulveda Blvd
#4
Van Nuys, CA 91405-1782

Mailing address

7301 Sepulveda Blvd
#4
Van Nuys, CA 91405-1782
Phone (818) 997-0315

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
50623CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaems Lim D D S Prof Corp Past Accepting new patients
NPI 1982214235 PastSince Aug 9, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1417157884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 SEPULVEDA BLVD",
            "address_2": "#4",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051782",
            "telephone_number": "818-997-0315",
            "fax_number": "818-997-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 SEPULVEDA BLVD",
            "address_2": "#4",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051782",
            "telephone_number": "818-997-0315",
            "fax_number": "818-997-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG ONE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.