Individual provider Active NPI

Curtis Kim, DDS

  • General Practice Dentistry
  • Livermore, CA
National Provider Identifier
1760065288
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107505 Issued in CA
Practice address
4375 First St
Livermore, CA 94551-4912
Phone
(925) 294-9288
NPI assigned
May 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
General Practice Dentistry 1223G0001X 107505 CA Primary

Addresses

Primary practice location

4375 First St
Livermore, CA 94551-4912

Mailing address

5801 Maymont LN
Dublin, CA 94568-7301
Phone (925) 989-6890

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230322002696 CA Order and Referring Only - DentistPractitioner - Dentist 7113391731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107505CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lopez and Lambridis Dental Corporation PastSince Aug 7, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1760065288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 MAYMONT LN",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945687301",
            "telephone_number": "925-989-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 FIRST ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945514912",
            "telephone_number": "925-294-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CURTIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore, CA

Sources for this page

Verify at the official NPI Registry.