Ji S Kim

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JI S KIM

Doing business as

Mauka Family Dental

Practice address

95-1095 Ainamakua Drive
Suite 5/7 a
Mililani, HI 96789

Phone

(808) 797-3044

Fax

(808) 797-3042

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

Ji S KimNPI 1740357755

Title

Business Owner

Phone

(808) 291-2487

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mauka Family Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ji S Kim, D.D.S., PLLC

  • General Practice Dentistry
  • Redford, MI
  • NPI 1740357755
  NPD Authorized official

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1790300614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1095 AINAMAKUA DRIVE",
            "address_2": "SUITE 5/7 A",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-797-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-1095 AINAMAKUA DRIVE",
            "address_2": "SUITE 5/7 A",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-797-3044",
            "fax_number": "808-797-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JI S KIM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "808-291-2487"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1740357755",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mauka Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaco Rehab Mililani LLC
• Jane Jamison, M.S.
• Shaelyn Jardine-Feiteira
• Louissa Jasper
• Tammylynn Jenkins
• Jasmine Jicha
• Lisa KT Jicha, LCSW, CSAC
• Juan Jinete
• JNM Medical LLC
• Ryan Johal, MD

• Dental Clinic/Center in Mililani, HI
• Providers in Mililani, HI by specialty
• Dental Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.