So Yeon Kim, D.D.M

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54627 Issued in CA

Practice address

2509 W McFadden Ave Ste E
Santa Ana, CA 92704-2747

Phone

(714) 835-8797

NPI assigned

Aug 27, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Soyeon Kim

  • Public Health Dentistry
  • Santa Ana, CA
  • NPI 1386054674
  NPD (past) Authorized official
• Koh Dental Corporation

  • Dentist
  • Santa Ana, CA
  • NPI 1003827395
  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1508290495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 W MCFADDEN AVE STE E",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927042747",
            "telephone_number": "714-835-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 W MCFADDEN AVE STE E",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927042747",
            "telephone_number": "714-835-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SO YEON",
        "name_prefix": "Dr.",
        "credential": "D.D.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Susie Kim
• Myong-Won Kim, MD
• Peter Hwa Kim, L.AC.
• Phoebe Kim, BEHAVIOR ANALYST
• Rye-Ji Kim
• Soojin Kim, NP
• Sook Ja Kim, PHARM. D.
• Thomas Kim, DO
• Victoria Pham Kim, DO
• William Kim

• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.