Gina Yeawon Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110180 Issued in CA

Practice address

6859 Magnolia Ave Ste 2
Riverside, CA 92506-2866

Phone

(951) 682-0810

Fax

(951) 289-9552

NPI assigned

Jun 21, 2024

Sex

Female

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

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.

• Young Kim Dental Corp

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1164922134
  NPD

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1528802840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6859 MAGNOLIA AVE STE 2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062866",
            "telephone_number": "951-682-0810",
            "fax_number": "951-289-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 MAGNOLIA AVE STE 2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062866",
            "telephone_number": "951-682-0810",
            "fax_number": "951-289-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GINA",
        "middle_name": "YEAWON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Kim
• Erin Ye-Jee Kim, PHARMD
• Esther Kim
• Esther Kim, PHARM.D
• Eunbin Kim
• Ha Neul Kim, NURSE PRACTITIONER
• Hannah Kim
• Helen Joo Kim, MD
• Ho Bin Kim, MD
• Hyung Koo Kim, M.D.

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, 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 Jun 21, 2024; 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.