Active NPI
Min Seok Kim DDS Inc
Doing business as Premiere Dental Care
- Dentist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54166
- Legal business name
- MIN SEOK KIM DDS INC
- Doing business as
- Premiere Dental Care
- Practice address
- 3680 Wilshire Blvd Ste 210
Los Angeles, CA 90010-2713 - Phone
- (213) 739-8855
- Fax
- (213) 739-8899
- NPI assigned
- Apr 8, 2008
- Last updated
- Apr 12, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Min Seok Kim, D.M.D.
- Title
- President
- Phone
- (213) 249-2319
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 54166 | CA | Primary |
Addresses
Primary practice location
3680 Wilshire Blvd Ste 210
Los Angeles, CA 90010-2713
Mailing address
3680 Wilshire Blvd Ste 210
Los Angeles, CA 90010-2713
Phone (213) 739-8855
Other names 1
- Premiere Dental Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3680 Wilshire Blvd
Ste 210
Los Angeles, CA 90010
Phone (213) 739-8855
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Hawthorne, CA
- NPI 1427218619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1555027200000",
"number": "1578736872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3680 WILSHIRE BLVD STE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102713",
"telephone_number": "213-739-8855",
"fax_number": "213-739-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3680 WILSHIRE BLVD STE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102713",
"telephone_number": "213-739-8855",
"fax_number": "213-739-8899"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIN SEOK KIM DDS INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-08",
"last_updated": "2019-04-12",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "MIN",
"authorized_official_middle_name": "SEOK",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "213-249-2319",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.M.D."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Premiere Dental Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Premiere Dental Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.