Hyun Woo Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

56711 Issued in CA

Practice address

25030 Alessandro Blvd Ste D
Moreno Valley, CA 92553-4383

Phone

(951) 924-0993

Fax

(951) 247-9693

NPI assigned

Jan 8, 2008

Reactivated

May 10, 2021

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

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.

• Hyun W Kim DDS Inc

  • Dentist
  • Rowland Heights, CA
  • NPI 1154076875
  NPD Authorized official
• Hyun W Kim DDS Inc

  • Dental Clinic/Center
  • Moreno Valley, CA
  • NPI 1295389815
  NPD Authorized official
• Stephen S Yang DDS Inc

  • General Practice Dentistry
  • Moreno Valley, CA
  • NPI 1356422166
  NPD (past)

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1497930457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25030 ALESSANDRO BLVD STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534383",
            "telephone_number": "951-924-0993",
            "fax_number": "951-247-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25030 ALESSANDRO BLVD STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534383",
            "telephone_number": "951-924-0993",
            "fax_number": "951-247-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYUN",
        "middle_name": "WOO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-08",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "deactivation_date": "2021-04-19",
        "reactivation_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo Kim, PT, DPT
• Erica E Kim, NP
• Eunice Kim
• Ha Eun Kim, DDS
• Hailey K Kim
• James Kim, O.M.D.
• Jason Sungwoo Kim
• Jaye Kim
• Kyungyeol Kim, L.AC
• Nathan Minsung Kim

• Dentist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.

Verify at the official NPI Registry.