Seung Hwan Kim, DDS, Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

65350 Issued in CA

Legal business name

SEUNG HWAN KIM, DDS, INC

Doing business as

Prime Dental Group Dr Kim

Practice address

13252 Century Blvd Ste Q
Garden Grove, CA 92843-1257

Phone

(714) 591-5190

NPI assigned

Jul 30, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Seung Hwan Kim, DDSNPI 1972964260

Title

Owner

Phone

(213) 505-2088

Specialties & licenses 1

Addresses

Other names 1

• PRIME DENTAL GROUP DR KIM Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Seung Hwan Kim, D.D.S

  • Dentist
  • Garden Grove, CA
  • NPI 1972964260
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1501372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689198806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13252 CENTURY BLVD STE Q",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431257",
            "telephone_number": "714-591-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13252 CENTURY BLVD STE Q",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431257",
            "telephone_number": "714-591-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEUNG HWAN KIM, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SEUNG HWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-505-2088",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "65350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME DENTAL GROUP DR KIM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yenitzy Serrano
• Jose Serrato, P.A.
• Maria Serratos
• Elaine Seth
• Lindsey Seto
• Miguel Sevilla
• Lane Seymour, DPT
• Shady Shaaban
• Shaaban,D.D.S.,Inc.
• Navyata Shah, DO

• Dental Clinic/Center in Garden Grove, CA
• Providers in Garden Grove, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.