Kenneth Won Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106354 Issued in CA

Practice address

6160 Arlington Ave Ste D4
Riverside, CA 92504-1900

Phone

(951) 637-0013

NPI assigned

Jul 28, 2021

Last updated

Jul 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kenneth W. Kim DDS, Apc

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1376210088
  NPD Authorized official

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1760155527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21056 MOUNTAIN GATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070001",
            "telephone_number": "909-248-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 ARLINGTON AVE STE D4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925041900",
            "telephone_number": "951-637-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KENNETH",
        "middle_name": "WON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Kim, LCSW
• Juhyen Kim
• Julie Kim
• Kei Chung Kim, OMD
• Kejia Kim, PHARM.D.
• Kristen S Kim
• Matthew Kim
• Mi Song Kim, MD
• Minyoung Kim, DDS
• Ok Suk Kim, MD

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, 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 Jul 28, 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.