Jin-Hyuk Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48484 Issued in CA

Practice address

14238 Valley Center Dr
#104
Victorville, CA 92395-4279

Phone

(760) 243-5437

Fax

(760) 243-2313

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

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

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.

• Jin-Hyuk Kim DDS Inc

  • Dentist
  • Victorville, CA
  • NPI 1619190394
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1669524153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14238 VALLEY CENTER DR",
            "address_2": "#104",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954279",
            "telephone_number": "760-243-5437",
            "fax_number": "760-243-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14238 VALLEY CENTER DR",
            "address_2": "#104",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954279",
            "telephone_number": "760-243-5437",
            "fax_number": "760-243-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN-HYUK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brennan Key
• Abanoub Khalil, PHARMD
• Andrew S. Khan, D.O.
• Eman J Khan
• Abdelrahman Khater
• Justine J Kim, FNP
• Kellee Kim
• Sang Jo Kim, L.AC.
• Taejune Kim
• Yoonah Kim

• General Practice Dentistry in Victorville, CA
• Providers in Victorville, 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 Aug 26, 2013; 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.