Dong Jin Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45277 Issued in CA

Practice address

69420 Ramon Rd
Cathedral City, CA 92234-3349

Phone

(760) 202-1171

Fax

(760) 202-1170

NPI assigned

May 25, 2007

Sex

Male

Sole proprietor

No

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)

Enrolled

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.

• Dong Jin Kim, DDS, Inc

  dba Pure Dental

  • Dental Clinic/Center
  • Cathedral City, CA
  • NPI 1346658622
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1588875116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69420 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343349",
            "telephone_number": "760-202-1171",
            "fax_number": "760-202-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69420 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343349",
            "telephone_number": "760-202-1171",
            "fax_number": "760-202-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONG",
        "middle_name": "JIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaycies Electrolysis and Skin Care PC
• Kristopher A Keene, PA-C
• David Mark Kennedy, DDS MS
• Marjorie Kennedy
• Richard Allen Kilmer, CMT
• Joann Celeste Koepp, R.N.
• Kortmeyer Chiropractic Inc
• David E. Kortmeyer, D.C.
• Zainab Kothari, PT
• Stephen Anthony Krupey, D.C.

• General Practice Dentistry in Cathedral City, CA
• Providers in Cathedral City, 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 10, 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.