NPIMap

Organization Active NPI

Yang Heon Kim DDS. Inc

  • Dentist
  • Fontana, CA
National Provider Identifier
1770813214
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48481 Issued in CA
Legal business name
YANG HEON KIM DDS. INC
Practice address
17736 San Bernardino Ave
Fontana, CA 92335-6133
Phone
(909) 822-4363
Fax
(909) 822-4476
NPI assigned
Jan 6, 2010
Last updated
Oct 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Authorized official

Name
Yang H Kim, D.D.S.NPI 1902970783
Title
President
Phone
(909) 822-4363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48481 CA Primary

Addresses

Primary practice location

17736 San Bernardino Ave
Fontana, CA 92335-6133

Mailing address

17736 San Bernardino Ave
Fontana, CA 92335-6133
Phone (909) 822-4363

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1770813214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17736 SAN BERNARDINO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356133",
            "telephone_number": "909-822-4363",
            "fax_number": "909-822-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17736 SAN BERNARDINO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356133",
            "telephone_number": "909-822-4363",
            "fax_number": "909-822-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANG HEON KIM DDS. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YANG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-822-4363",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.