Individual provider Active NPI

Chun K Kim, DDS

  • Dentist
  • Rancho Mirage, CA
National Provider Identifier
1710049887
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
259200 Issued in CA
Practice address
35900 Bob Hope Drive Ste 110
TMJ Head and Neck Pain Center
Rancho Mirage, CA 92270
Phone
(760) 770-4033
Fax
(760) 770-3975
NPI assigned
Dec 15, 2006
Last updated
Nov 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 259200 CA Primary

Addresses

Primary practice location

35900 Bob Hope Drive Ste 110
TMJ Head and Neck Pain Center
Rancho Mirage, CA 92270

Mailing address

35900 Bob Hope Drive Ste 110
TMJ Head and Neck Pain Center
Rancho Mirage, CA 92270
Phone (760) 770-4033

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
259200CAMDDentist
25920CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee & Byeoun, DDS, Inc. CurrentSince Feb 6, 2022 Accepting new patients

Locations

35900 Bob Hope Dr
Ste 110
Rancho Mirage, CA 92270
Phone (760) 770-4033

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1710049887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35900 BOB HOPE DRIVE STE 110",
            "address_2": "TMJ HEAD AND NECK PAIN CENTER",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-770-4033",
            "fax_number": "760-770-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35900 BOB HOPE DRIVE STE 110",
            "address_2": "TMJ HEAD AND NECK PAIN CENTER",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-770-4033",
            "fax_number": "760-770-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHUN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "259200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.