Kim Shimazu & Lee Dental Corp

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

36953 Issued in CA

Legal business name

KIM SHIMAZU & LEE DENTAL CORP

Practice address

12865 Main St Ste #201
Garden Grove, CA 92840

Phone

(714) 530-7888

Fax

(714) 530-1344

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Hwangsuk Kim, DDS

Title

Owner

Phone

(714) 530-7888

Specialties & licenses 1

Addresses

Other names 1

• Ivy Endodontic Group Doing business as

Tax ID family

Ivy Endodontic Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kim Shimazu & Lee Dental Corp

  • Endodontics
  • Irvine, CA
  • NPI 1982882072
  NPD tax ID

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629186176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE #201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92840",
            "telephone_number": "714-530-7888",
            "fax_number": "714-530-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE #201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92840",
            "telephone_number": "714-530-7888",
            "fax_number": "714-530-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM SHIMAZU & LEE DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "HWANGSUK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-530-7888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "36953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy Endodontic Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Kiarie
• Kid Fundamentals Therapy Center, Inc.
• Maki Kido, BCBA
• Misa Kieu
• Elizabeth Ann Kilpatrick
• Boung Kim I, DDS
• Chan S Kim, MD
• Cheon Young Kim, O.M.D.
• Daniel Kim, DPT
• Daniel D Kim, D.C.

• Endodontics in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Endodontics 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.