NPIMap

Organization Active NPI

Ha Jung Kim, Dds45-321953

Doing business as Gonzales Dental Care

  • Dental Clinic/Center
  • Gonzales, CA
National Provider Identifier
1427465236
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HA JUNG KIM, DDS45-321953
Doing business as
Gonzales Dental Care
Practice address
851 5TH St Ste H
Gonzales, CA 93926-9437
Phone
(831) 240-0865
NPI assigned
Jul 14, 2014
Last updated
Jul 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Authorized official

Name
Ha Jung KimNPI 1275772063
Title
General Dentist
Phone
(831) 240-0865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

851 5TH St Ste H
Gonzales, CA 93926-9437

Mailing address

851 5TH St Ste H
Gonzales, CA 93926-9437
Phone (831) 240-0865

Other names 1

  • Gonzales Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

851 5th St
Ste H
Gonzales, CA 93926
Phone (831) 240-0865

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1427465236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 5TH ST STE H",
            "city": "GONZALES",
            "state": "CA",
            "postal_code": "939269437",
            "telephone_number": "831-240-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 5TH ST STE H",
            "city": "GONZALES",
            "state": "CA",
            "postal_code": "939269437",
            "telephone_number": "831-240-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HA JUNG KIM, DDS45-321953",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HA JUNG",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "831-240-0865"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gonzales Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.