Kosal Kom, DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41442 Issued in CA

Legal business name

KOSAL KOM, DDS, INC

Practice address

2338 E Anaheim St
Suite 108
Long Beach, CA 90804-5730

Phone

(562) 434-9980

NPI assigned

Aug 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kosal Kom, DDSNPI 1710034566

Title

President

Phone

(562) 434-9980

Specialties & licenses 1

Addresses

Other names 1

• Kosal Kom, DDS Former legal business name

Locations

Practitioners 1

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

• Kosal Kom, D.D.S.

  • General Practice Dentistry
  • Long Beach, CA
  • NPI 1710034566
  NPD (past) Authorized official

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249257600000",
    "number": "1689805012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 E ANAHEIM ST",
            "address_2": "SUITE 108",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908045730",
            "telephone_number": "562-434-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 E ANAHEIM ST",
            "address_2": "SUITE 108",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908045730",
            "telephone_number": "562-434-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSAL KOM, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A",
        "authorized_official_last_name": "KOM",
        "authorized_official_first_name": "KOSAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-434-9980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kosal Kom, DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Marcin Kopec, MD
• Rishi Ram Kora
• Rekhashree Koratagere Shivananda
• Peter L. Korchin, CO
• Terrell Kornegay
• Faith Koscal, AMFT
• Kathleen Ann Kosche, LCSW
• Perry R Koseff, DO
• Jennifer Kosel, RKT
• Nicholas Elijah Kosht

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, 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 3, 2009; 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.