Active NPI
David Dae Kim, D.D.S.
- Dentist
- Norwalk, CA
National Provider Identifier
1497078216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 43705
- Practice address
- 15919 Pioneer Blvd
Norwalk, CA 90650-7117 - Phone
- (562) 991-5066
- NPI assigned
- Mar 8, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 43705 | CA | Primary |
Addresses
Primary practice location
15919 Pioneer Blvd
Norwalk, CA 90650-7117
Mailing address
15919 Pioneer Blvd
Norwalk, CA 90650-7117
Phone (562) 991-5066
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 |
|---|---|---|---|
| 43705 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1497078216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15919 PIONEER BLVD",
"city": "NORWALK",
"state": "CA",
"postal_code": "906507117",
"telephone_number": "562-991-5066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15919 PIONEER BLVD",
"city": "NORWALK",
"state": "CA",
"postal_code": "906507117",
"telephone_number": "562-991-5066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DAVID",
"middle_name": "DAE",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-08",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "43705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.