A.S. Kim DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55536 Issued in CA

Legal business name

A.S. KIM DDS, INC.

Doing business as

Village Hillcrest Dental

Practice address

501 Washington St Ste 740
San Diego, CA 92103-2231

Phone

(619) 296-2172

NPI assigned

Oct 10, 2016

Last updated

Apr 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anne Sooyun Kim, DDSNPI 1275654501

Title

Ceo

Phone

(734) 657-9694

Specialties & licenses 1

Addresses

Other names 1

• Village Hillcrest Dental Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anne Sooyun Kim, DDS

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1275654501
  NPD Authorized official
• Robert Alan Adler, DDS

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1578769618
  NPD (past)
• David Sungho Ahn, MD

  • Pediatrics Physician
  • Apple Valley, CA
  • NPI 1083761084
  NPD (past)

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1730639188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 LA CRESTA WAY",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022575",
            "telephone_number": "734-657-9694",
            "fax_number": "619-296-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST STE 740",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-296-2172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Washington St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032208",
            "country_code": "US",
            "telephone_number": "619-296-6136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A.S. KIM DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "SOOYUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-657-9694",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Hillcrest Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Hillcrest Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 Apr 26, 2021; 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.