Active NPI
Dustin Kim, DMD
- Dentist
- Bakersfield, CA
National Provider Identifier
1780093203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64398
- Practice address
- 4900 California Ave Ste 400B
Bakersfield, CA 93309-7081 - Phone
- (661) 459-7049
- NPI assigned
- Aug 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2014024597 | MO | |
| Dentist | 122300000X | 64398 | CA | Primary |
Addresses
Primary practice location
4900 California Ave Ste 400B
Bakersfield, CA 93309-7081
Mailing address
4900 California Ave Ste 400B
Bakersfield, CA 93309-7081
Phone (661) 459-7049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64398 | CA | MD | Dentist |
| 2014024597 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464307200000",
"number": "1780093203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 CALIFORNIA AVE STE 400B",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933097081",
"telephone_number": "661-459-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 CALIFORNIA AVE STE 400B",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933097081",
"telephone_number": "661-459-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DUSTIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-08",
"last_updated": "2016-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2014024597",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.