Organization Active NPI

Peace Kim Dentistry, Inc.

  • Dentist
  • Long Beach, CA
National Provider Identifier
1548754260
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63279 Issued in CA
Legal business name
PEACE KIM DENTISTRY, INC.
Practice address
3840 Woodruff Ave Ste 107
Long Beach, CA 90808-2148
Phone
(562) 421-3764
NPI assigned
Jun 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Peace Kim, DDS
Title
Ceo, DDS
Phone
(949) 232-7965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 63279 CA Primary

Addresses

Primary practice location

3840 Woodruff Ave Ste 107
Long Beach, CA 90808-2148

Mailing address

4 Longbourn Aisle
Irvine, CA 92603-5722

National Provider Directory

National Provider Directory

Locations

3840 Woodruff Ave
Ste 107
Long Beach, CA 90808
Phone (562) 421-3764

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1548754260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONGBOURN AISLE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926035722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 WOODRUFF AVE STE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082148",
            "telephone_number": "562-421-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE KIM DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PEACE",
        "authorized_official_title_or_position": "CEO, DDS",
        "authorized_official_telephone_number": "949-232-7965",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "63279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.