Dr. Kim Phung, P. C.

Primary specialty

DentistTaxonomy code 122300000X

License

45756 Issued in CA

Legal business name

DR. KIM PHUNG, P. C.

Practice address

7970 Princevalle St
Gilroy, CA 95020-5027

Phone

(408) 842-9439

Fax

(408) 842-9475

NPI assigned

Aug 7, 2015

Organization subpart

No

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

Authorized official

Name

Kim K Phung, D.D.S

Title

Ceo

Phone

(408) 842-9439

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1609252097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7970 PRINCEVALLE ST",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205027",
            "telephone_number": "408-842-9439",
            "fax_number": "408-842-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7970 PRINCEVALLE ST",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205027",
            "telephone_number": "408-842-9439",
            "fax_number": "408-842-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KIM PHUNG, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-842-9439",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "45756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.