James Kim Tan, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

63884 Issued in CA

Practice address

5803 Candlewood St
Lakewood, CA 90713-1828

Phone

(562) 882-4208

NPI assigned

Mar 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651363200000",
    "number": "1609141530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 CANDLEWOOD ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131828",
            "telephone_number": "562-882-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 CANDLEWOOD ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131828",
            "telephone_number": "562-882-4208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 W 98th St Apt 11D",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100255516",
            "country_code": "US",
            "telephone_number": "562-882-4208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "JAMES",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-10",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karmbir Takhar, FNP
• Alyssa Nicole Talavera
• Talbert Medical Group, P.C.
• Anne Tallent
• Anna Talonova
• Kevin Tan
• Layheang Tang, PHARMD
• Kendra Venetta Tankersley, BS
• Taryn Tanner, NP
• Roger Milton Tauran, M.D., M.P.H.

• Dentist in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; 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.