Angela Eunkyung Kim, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56443 Issued in CA

Practice address

230 E 17TH St
208
Costa Mesa, CA 92627-3824

Phone

(949) 645-0045

Fax

(949) 645-0055

NPI assigned

Sep 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Costa Mesa Corp.

  • Dentist
  • Costa Mesa, CA
  • NPI 1508015603
  NPD (past)
• JJ Kim Dental Corporation

  • Dental Clinic/Center
  • Anaheim, CA
  • NPI 1043910110
  NPD (past)

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1629527767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 17TH ST",
            "address_2": "208",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273824",
            "telephone_number": "949-645-0045",
            "fax_number": "949-645-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 17TH ST",
            "address_2": "208",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273824",
            "telephone_number": "949-645-0045",
            "fax_number": "949-645-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANGELA",
        "middle_name": "EUNKYUNG",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khiem D. Dao, MD, Inc.
• Mariana Khoury
• Kyndall Rae Kieler
• Mia'Ariarna Kilekas, PA-C, MSPA
• Allison Joy Killough
• Audrey Kim
• Chung Eun Kim
• Heidi Gina Kim
• Jerrad Kim
• Jessica Kim, MS

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, 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 Sep 30, 2016; 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.