Stephen Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58231 Issued in CA

Practice address

7841 Commonwealth Ave
Buena Park, CA 90621-2422

Phone

(714) 739-7173

Fax

(714) 739-7174

NPI assigned

Nov 30, 2006

Last updated

Jan 31, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1659449791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7841 COMMONWEALTH AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212422",
            "telephone_number": "714-739-7173",
            "fax_number": "714-739-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7841 COMMONWEALTH AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212422",
            "telephone_number": "714-739-7173",
            "fax_number": "714-739-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0515061",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02664253",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Yerim Kim
• Samuel Kim
• Sangjun Kim
• So H Kim
• Soohyun Kim
• Sueyon Kim, CCC-SLP
• Sung Hyun Kim, M.D
• Tai-Won Kim, MD
• Yejin Kim, DDS
• Yong Ook Kim, LAC

• General Practice Dentistry in Buena Park, CA
• Providers in Buena Park, 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 Jan 31, 2011; 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.