Individual provider Active NPI

Steven S Kim, DDS

  • General Practice Dentistry
  • Chino Hills, CA
National Provider Identifier
1750478582
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
CA 31302 Issued in CA
Practice address
2983 Chino Ave Ste A5
Chino Hills, CA 91709-3576
Phone
(909) 628-7000
Fax
(909) 628-6039
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X CA 31302 CA Primary

Addresses

Primary practice location

2983 Chino Ave Ste A5
Chino Hills, CA 91709-3576

Mailing address

2983 Chino Ave Ste A5
Chino Hills, CA 91709-3576
Phone (909) 628-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608002743 CA Order and Referring Only - Other (Non-Physician) 3476874074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CA 31302CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Steven DBD Inc General Practice CurrentSince Dec 9, 2019 Accepting new patients

Locations

2983 Chino Ave
Ste A5
Chino Hills, CA 91709
Phone (909) 517-0005

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750478582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2983 CHINO AVE STE A5",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093576",
            "telephone_number": "909-628-7000",
            "fax_number": "909-628-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2983 CHINO AVE STE A5",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093576",
            "telephone_number": "909-628-7000",
            "fax_number": "909-628-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEVEN",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "CA 31302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.