John Y Kim DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5654 Issued in AZ

Legal business name

JOHN Y KIM DDS, PC

Practice address

14545 W Grand Ave
Suite 111
Surprise, AZ 85374-7278

Phone

(623) 975-9775

Fax

(623) 975-9449

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Kim, DDSNPI 1902986250

Title

President

Phone

(623) 975-9775

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• John Y. Kim, D.D.S.

  • Dentist
  • Surprise, AZ
  • NPI 1902986250

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710107305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 W GRAND AVE",
            "address_2": "SUITE 111",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747278",
            "telephone_number": "623-975-9775",
            "fax_number": "623-975-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 W GRAND AVE",
            "address_2": "SUITE 111",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747278",
            "telephone_number": "623-975-9775",
            "fax_number": "623-975-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN Y KIM DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-975-9775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Steven Jensen, DPM
• Naomi Nicole Jimenez, NP
• Gene Jiongco, PHARMD
• JMJ Enterpise LLC
• Angela Johansson, DO
• Abimbola Johnson, PHARM.D.
• Beuresa K. Johnson
• Brady James Johnson, DC
• Diane Nicole Johnson, PA-C
• Donna Rae Johnson, L.P.N.

• General Practice Dentistry in Surprise, AZ
• Providers in Surprise, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.