Edward Kim Dental Corp.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48729 Issued in CA

Legal business name

EDWARD KIM DENTAL CORP.

Practice address

2685 Cochran St
Simi Valley, CA 93065-2664

Phone

(805) 582-1900

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Edward Kim, DDSNPI 1649644279

Title

President

Phone

(805) 582-1900

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Edward Kim, DDS

  • General Practice Dentistry
  • Simi Valley, CA
  • NPI 1649644279
  NPD (past) Authorized official

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598974404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 COCHRAN ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652664",
            "telephone_number": "805-582-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 COCHRAN ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652664",
            "telephone_number": "805-582-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD KIM DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-582-1900",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Simi Valley, CA
• Providers in Simi Valley, 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 Aug 22, 2020; 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.