Active NPI
Dong-Hyun Kim, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1629458377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62191
- Practice address
- 12121 Wilshire Blvd
Suite 1111
Los Angeles, CA 90025-1123 - Phone
- (310) 820-9933
- NPI assigned
- Jun 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62191 | CA | Primary |
Addresses
Primary practice location
12121 Wilshire Blvd
Suite 1111
Los Angeles, CA 90025-1123
Mailing address
700 N Valley St Ste B
#18311
Anaheim, CA 92801-3824
Phone (213) 357-9467
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62191 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1629458377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 N VALLEY ST STE B",
"address_2": "#18311",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928013824",
"telephone_number": "213-357-9467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12121 WILSHIRE BLVD",
"address_2": "SUITE 1111",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251123",
"telephone_number": "310-820-9933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DONG-HYUN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-08",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.