Jiyeon J Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63963 Issued in CA

Practice address

2262 Pacific Coast Hwy
Lomita, CA 90717-2532

Phone

(310) 530-3790

NPI assigned

Sep 24, 2014

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

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.

• J D E Bilbao DDS

  • General Practice Dentistry
  • Lomita, CA
  • NPI 1225448863
  NPD (past)

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1568864262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 WILSHIRE BLVD",
            "address_2": "APT 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103718",
            "telephone_number": "424-777-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2262 PACIFIC COAST HWY",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172532",
            "telephone_number": "310-530-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIYEON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Louis Keller, MD
• Amir Khan, PHARM.D.
• Kaleem Assadullah Khan, MD
• Andrew Taeho Kim
• Esther Jeong Kim
• Joseph Kim
• Jung Kyung Kim
• Sun Y Kim, DDS
• Tae Kim, L.AC
• You Joo Kim, L.AC.,PH.D.

• General Practice Dentistry in Lomita, CA
• Providers in Lomita, 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 Sep 24, 2014; 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.