Suk Won Kim

Primary specialty

DentistTaxonomy code 122300000X

License

108979 Issued in CA

Practice address

211 Eastmoor Ave
Daly City, CA 94015-2036

Phone

(650) 550-3923

NPI assigned

Apr 14, 2022

Last updated

Sep 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1750024238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EASTMOOR AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152036",
            "telephone_number": "650-550-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EASTMOOR AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152036",
            "telephone_number": "650-550-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUK WON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anadelia B Kim, NP
• Esther Jin Kim, M.D.
• Han Seong Kim, D.C.
• Jennifer Wiley Kim
• Rachel Kim, PH.D
• Yong Hyeon Kim, D.C, LA.C
• Marya Susan Kimple, MS
• Tomoki Kimura, MD
• Christina King
• Jenna Ariel King

• Dentist in Daly City, CA
• Providers in Daly City, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.