Active NPI
Bock J Kim, DDS
- Dentist
- Bell Gardens, CA
National Provider Identifier
1528112968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48728
- Practice address
- 6501 Eastern Ave
#B
Bell Gardens, CA 90201 - Phone
- (323) 773-2082
- Fax
- (323) 560-3905
- NPI assigned
- Jan 23, 2007
- 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 | 48728 | CA | Primary |
Addresses
Primary practice location
6501 Eastern Ave
#B
Bell Gardens, CA 90201
Mailing address
6501 Eastern Ave
#B
Bell Gardens, CA 90201
Phone (323) 773-2082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528112968 | Other | CA | DENTICAL |
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 |
|---|---|---|---|
| 48728 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bock Jung Kim DDS Inc | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Los Angeles, CA
- NPI 1033789888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1528112968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6501 EASTERN AVE",
"address_2": "#B",
"city": "BELL GARDENS",
"state": "CA",
"postal_code": "90201",
"telephone_number": "323-773-2082",
"fax_number": "323-560-3905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 EASTERN AVE",
"address_2": "#B",
"city": "BELL GARDENS",
"state": "CA",
"postal_code": "90201",
"telephone_number": "323-773-2082",
"fax_number": "323-560-3905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BOCK",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "48728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "1528112968",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bell Gardens, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.