James Young Kim, D.D.S INC.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34506 Issued in CA

Practice address

15890 Gale Ave
Hacienda Heights, CA 91745-1601

Phone

(626) 333-0111

Fax

(626) 333-2400

NPI assigned

Jan 2, 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

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1710044771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15890 GALE AVE",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917451601",
            "telephone_number": "626-333-0111",
            "fax_number": "626-333-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15890 GALE AVE",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917451601",
            "telephone_number": "626-333-0111",
            "fax_number": "626-333-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAMES",
        "middle_name": "YOUNG",
        "credential": "D.D.S INC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL REVENUE SERVICE",
            "identifier": "26-3123994",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Hong-Yu Kao, D.D.S.
• Diana Kelley
• Kendrick NG a Medical Corp
• Minnie Kil
• Annie Kim
• Kevin Yongkwan Kim
• Zee Hyun Kim
• Holly King
• Yi Jasmine Ko, DDS
• Hassan A Kobaissi, DPM

• General Practice Dentistry in Hacienda Heights, CA
• Providers in Hacienda Heights, 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 Jun 8, 2010; 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.