Timothy Kook, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

104316 Issued in CA

Practice address

813 Fair Oaks Ave
South Pasadena, CA 91030-2605

Phone

(925) 451-5649

NPI assigned

Oct 1, 2019

Sex

Male

Sole proprietor

No

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 CA

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 1

Specialty

Dentist

Education

New York University College of Dentistry, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1780877613
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  • Clinic/Center
  • Lancaster, CA
  • NPI 1366453045
  NPD

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1467093419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 N MARENGO AVE APT 204",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911014520",
            "telephone_number": "925-451-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FAIR OAKS AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302605",
            "telephone_number": "925-451-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOK",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-01",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braley Brooke Klatt
• Dawn Knight
• Cynthia Chizuko Kodama, D.O.
• Kaitlyn Mieko Kodama
• Bonjun Koo
• Sarah Kovatch, MA
• John Krabbe
• Joanna Ku
• Mallory Kujanek
• Kirsten Joy Kuns, LMFT

• Dentist in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.