NPIMap

Organization Active NPI

Paul Kim DMD,Inc

  • Dentist
  • Cerritos, CA
National Provider Identifier
1730501263
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40253 Issued in CA
Legal business name
PAUL KIM DMD,INC
Practice address
11900 South St Ste 122
Cerritos, CA 90703-6800
Phone
(562) 809-6177
Fax
(562) 809-7659
NPI assigned
Jan 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Authorized official

Name
Dr. Paul Kim, DMDNPI 1134266109
Title
President
Phone
(562) 809-6177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 40253 CA Primary

Addresses

Primary practice location

11900 South St Ste 122
Cerritos, CA 90703-6800

Mailing address

11900 South St Ste 122
Cerritos, CA 90703-6800
Phone (562) 809-6177

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389916800000",
    "number": "1730501263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 SOUTH ST STE 122",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036800",
            "telephone_number": "562-809-6177",
            "fax_number": "562-809-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 SOUTH ST STE 122",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036800",
            "telephone_number": "562-809-6177",
            "fax_number": "562-809-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL KIM DMD,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-01-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-809-6177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; 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.