Jae J. Kim, D.D.S., Inc

Primary specialty

DentistTaxonomy code 122300000X

License

27010 Issued in CA

Legal business name

JAE J. KIM, D.D.S., INC

Practice address

17476 Colima Rd.
Rowland Heights, CA 91748

Phone

(626) 810-8008

Fax

(626) 810-2124

NPI assigned

Feb 5, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jae Jong Kim, D.D.S.

Title

President

Phone

(626) 810-8008

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1487045944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17476 COLIMA RD.",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-810-8008",
            "fax_number": "626-810-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17476 COLIMA RD.",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-810-8008",
            "fax_number": "626-810-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE J. KIM, D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAE JONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-810-8008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "27010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Rowland Heights, CA
• Providers in Rowland Heights, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.