Active NPI
Christine Jihae Kim, D.D.S.
- Dentist
- Irvine, CA
National Provider Identifier
1437608361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 65174
- Practice address
- 6 Appomattox
Irvine, CA 92620 - Phone
- (949) 701-3059
- NPI assigned
- Oct 4, 2016
- Last updated
- Oct 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 65174 | CA | Primary |
Addresses
Primary practice location
6 Appomattox
Irvine, CA 92620
Mailing address
6 Appomattox
Irvine, CA 92620-3717
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200308000039 | CA | Order and Referring Only - Dentist | 5991133837 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65174 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1437608361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 APPOMATTOX",
"city": "IRVINE",
"state": "CA",
"postal_code": "926203717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 APPOMATTOX",
"city": "IRVINE",
"state": "CA",
"postal_code": "92620",
"telephone_number": "949-701-3059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHRISTINE",
"middle_name": "JIHAE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "65174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.