Active NPI
Enoch Kim, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Laguna Hills, CA
National Provider Identifier
1790912160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 57217
- Practice address
- 25272 McIntyre St
Suite a
Laguna Hills, CA 92653-5449 - Phone
- (949) 472-9155
- NPI assigned
- Jun 12, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 57217 | CA | Primary |
Addresses
Primary practice location
25272 McIntyre St
Suite a
Laguna Hills, CA 92653-5449
Mailing address
25272 McIntyre St
Suite a
Laguna Hills, CA 92653-5449
Phone (949) 472-9155
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 |
|---|---|---|---|
| 57217 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244764800000",
"number": "1790912160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25272 MCINTYRE ST",
"address_2": "SUITE A",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926535449",
"telephone_number": "949-472-9155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25272 MCINTYRE ST",
"address_2": "SUITE A",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926535449",
"telephone_number": "949-472-9155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ENOCH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-12",
"last_updated": "2009-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "57217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.