Matthew Kim DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MATTHEW KIM DDS INC

Practice address

1101 W Tokay St Ste 2
Lodi, CA 95240-3842

Phone

(209) 334-0760

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Matthew Kim, DDSNPI 1184399529

Title

Ceo

Phone

(209) 334-0760

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Matthew Kim, DDS

  • General Practice Dentistry
  • Lodi, CA
  • NPI 1184399529
  NPD Authorized official
• Patrick T Sweeney, DDS

  • General Practice Dentistry
  • Lodi, CA
  • NPI 1376640466
  NPD (past)

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1740062736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W TOKAY ST STE 2",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403842",
            "telephone_number": "209-334-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W TOKAY ST STE 2",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403842",
            "telephone_number": "209-334-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW KIM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-334-0760",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasnim Masood, NP
• Wasim Masood
• Matrix Rehabilitation, Inc. (Advanced Physical Therapy-Lodi)
• Mykenzie Lauren Mattheis, DO
• Matthew Fava
• Allen Mau, D.D.S.
• Amanda Ellen Mauch, LE
• Abelardo Verceles Mayo, MD
• Mays Chiropractic Corp
• Mitchell Brian Mays, D.C.

• Dental Clinic/Center in Lodi, CA
• Providers in Lodi, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.