Whittier Modern Dentistry Dental Group

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WHITTIER MODERN DENTISTRY DENTAL GROUP

Practice address

11806 Whittier Blvd Ste E
Whittier, CA 90601-4622

Phone

(562) 513-1146

Fax

(562) 513-5142

NPI assigned

Aug 15, 2022

Organization subpart

No

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

Authorized official

Name

Christina M Kim, DMD

Title

Owner Doctor

Phone

(562) 513-1146

Specialties & licenses 1

Addresses

Other names 1

• Whittier Modern Dentistry Doing business as

Locations

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1508584756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11806 WHITTIER BLVD STE E",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014622",
            "telephone_number": "562-513-1146",
            "fax_number": "562-513-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITTIER MODERN DENTISTRY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "562-513-1146",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whittier Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Whittier, CA
• Providers in Whittier, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.