Individual provider Active NPI

Mi Hyun Kim, DDS

  • Dentist
  • Berkeley, CA
National Provider Identifier
1699766717
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62385 Issued in CA
Practice address
3000 Colby St Ste 300
Berkeley, CA 94705-2058
Phone
(510) 548-0570
Fax
(510) 548-5417
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62385 CA Primary

Addresses

Primary practice location

3000 Colby St Ste 300
Berkeley, CA 94705-2058

Mailing address

3000 Colby St Ste 300
Berkeley, CA 94705-2058
Phone (510) 548-0570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1699766717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 COLBY ST STE 300",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052058",
            "telephone_number": "510-548-0570",
            "fax_number": "510-548-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLBY ST STE 300",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052058",
            "telephone_number": "510-548-0570",
            "fax_number": "510-548-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MI HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.