Hyung Tack Kim, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

55714 Issued in CA

Practice address

2681 W Olympic Blvd Ste 220
Los Angeles, CA 90006-2883

Phone

(213) 251-8999

Fax

(213) 251-8909

NPI assigned

Jun 8, 2007

Last updated

Mar 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Oral Surgery

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hyung T Kim DDS Inc.

  • General Practice Dentistry
  • Long Beach, CA
  • NPI 1164859096
  Authorized official Same address or phone
• M H Hansen DPM PLC

  dba Cactus Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • Chandler, AZ
  • NPI 1275718447
  NPD

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1457554123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 CHANTILLY LN",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331289",
            "telephone_number": "310-893-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2681 W OLYMPIC BLVD STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062883",
            "telephone_number": "213-251-8999",
            "fax_number": "213-251-8909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 W Olympic Blvd # A",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900062316",
            "country_code": "US",
            "telephone_number": "213-251-8999",
            "fax_number": "213-251-8909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYUNG",
        "middle_name": "TACK",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyun Sook Kim, L. AC
• Hyun Wook Kim, DDS
• Hyung Kim, M.D.
• Hyung Kim, MD
• Hyung Lae Kim, LCSW
• Hyung-Ju John Kim
• Hyungsoo Kim, D.C
• Hyunil Kim
• Hyunji Kim, DMD
• Hyunseok Kim, MD

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.