Hyunji Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS105848 Issued in CA

Practice address

1120 S Grand Ave Apt 1216
Los Angeles, CA 90015-4388

Phone

(913) 306-1281

NPI assigned

May 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Natick Dental Partners LLP

  • Pediatric Dentistry
  • Natick, MA
  • NPI 1689711509
  NPD (past)

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1639557739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S GRAND AVE APT 1216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154388",
            "telephone_number": "913-306-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S GRAND AVE APT 1216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154388",
            "telephone_number": "913-306-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYUNJI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857629",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105848",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS105848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639557739",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@gotfloss.com",
            "affiliation": "N",
            "address_1": "230 Pond St",
            "city": "Natick",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017604323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hyung Lae Kim, LCSW
• Hyung Tack Kim, D.D.S
• Hyung-Ju John Kim
• Hyungsoo Kim, D.C
• Hyunil Kim
• Hyunseok Kim, MD
• Hyunsik Kim
• Hyunyoung Kim, MS CCC-SLP
• Il Young Kim, M.D.
• Ilhyung Kim, L.AC

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.