William Dae Won Kim D.D.S. a Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WILLIAM DAE WON KIM D.D.S. A DENTAL CORPORATION

Practice address

906 N Vermont Ave
Los Angeles, CA 90029-3519

Phone

(323) 522-3382

NPI assigned

Apr 7, 2025

Organization subpart

No

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

Authorized official

Name

Dr. William Dae Won Kim, DDSNPI 1366923146

Title

Dentist

Phone

(213) 270-5432

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• oxy dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Dae Won Kim, DDS

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1366923146
  NPD Authorized official

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1639963473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 QUEENSBERRY RD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911043440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293519",
            "telephone_number": "323-522-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM DAE WON KIM D.D.S. A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAE WON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "213-270-5432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366923146",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "oxy dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Willett
• Janet Willey
• Ariel Lynn Willham-White
• Pollie Willhite, CRNA
• William Cottles, Jr., M.D.,Inc.
• William Daniel Keith Jr MD Inc
• William Dennis Pagliano, DPM Inc.
• William E Faulkner DDS Inc
• William E Hitselberger M D Inc
• William F Stubbeman MD a Professional Corporation

• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.