Changsook Kim DDS a Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39166 Issued in CA

Legal business name

CHANGSOOK KIM DDS A DENTAL CORP

Practice address

1755 E Huntington Dr
#101
Duarte, CA 91010

Phone

(626) 357-9909

Fax

(626) 358-7245

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Changsook Kim, DDSNPI 1114034139

Title

Dentist

Phone

(626) 357-9909

Specialties & licenses 2

Addresses

Practitioners 1

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

• Changsook Kim, DDS

  • Dentist
  • Duarte, CA
  • NPI 1114034139
  NPD (past) Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1710018254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 E HUNTINGTON DRIVE",
            "address_2": "#101",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-357-9909",
            "fax_number": "626-358-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 E HUNTINGTON DR",
            "address_2": "#101",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-357-9909",
            "fax_number": "626-358-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGSOOK KIM DDS A DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHANGSOOK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "626-357-9909",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "39166CA",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Chang, MD
• Joseph Chang
• Karen Chang, MD
• Sue Chang, MD
• Walter Chang, MD
• Cherng Chao, MD
• Joseph Chao, M.D.
• Katherine Xuanmei Chao, RPH, PHARMD
• Ammar Ahmed Chaudhry, M.D.
• Marta Leticia Chavarria

• General Practice Dentistry in Duarte, CA
• Providers in Duarte, 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 Jul 11, 2008; 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.