NPIMap

Organization Active NPI

Jang Kil Yi DDS Professional Dental Corporation

  • Dentist
  • Huntington Park, CA
National Provider Identifier
1588084040
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28641 Issued in CA
Legal business name
JANG KIL YI DDS PROFESSIONAL DENTAL CORPORATION
Practice address
5914 Pacific Blvd
Huntington Park, CA 90255-2929
Phone
(323) 581-0100
NPI assigned
Apr 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Authorized official

Name
Dr. Jang Kil Yi, D.D.S.NPI 1073641098
Title
Dentist
Phone
(323) 581-0100

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)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 28641 CA Primary

Addresses

Primary practice location

5914 Pacific Blvd
Huntington Park, CA 90255-2929

Mailing address

5914 Pacific Blvd
Huntington Park, CA 90255-2929

National Provider Directory

National Provider Directory

Locations

5914 Pacific Blvd
Huntington Park, CA 90255
Phone (323) 581-0100

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": "1398211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1588084040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5914 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5914 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552929",
            "telephone_number": "323-581-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANG KIL YI DDS PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "YI",
        "authorized_official_first_name": "JANG",
        "authorized_official_middle_name": "KIL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "323-581-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "28641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.