Active NPI
Roy H Kim, D.D.S.
- General Practice Dentistry
- Foothill Ranch, CA
National Provider Identifier
1437417391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 64548
- Practice address
- 26720 Towne Centre Dr Ste B
Foothill Ranch, CA 92610-2840 - Phone
- (949) 830-2003
- Fax
- (949) 830-2017
- NPI assigned
- Apr 30, 2012
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 64548 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
26720 Towne Centre Dr Ste B
Foothill Ranch, CA 92610-2840
Mailing address
26720 Towne Centre Dr Ste B
Foothill Ranch, CA 92610-2840
Phone (949) 830-2003
Other practice location 1
111 E 210th St
Montefiore Medical Center
Bronx, NY 10467-2401
Phone (718) 920-6266
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
| License | State | Type | Specialty |
|---|---|---|---|
| 64548 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mauricio Cardenas DDS Inc | Past | 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": "1335744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1437417391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26720 TOWNE CENTRE DR STE B",
"city": "FOOTHILL RANCH",
"state": "CA",
"postal_code": "926102840",
"telephone_number": "949-830-2003",
"fax_number": "949-830-2017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26720 TOWNE CENTRE DR STE B",
"city": "FOOTHILL RANCH",
"state": "CA",
"postal_code": "926102840",
"telephone_number": "949-830-2003",
"fax_number": "949-830-2017"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_2": "Montefiore Medical Center",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-920-6266",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "ROY",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "64548",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Foothill Ranch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.