Namgu Kim

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

106535 Issued in CA

Practice address

11635 South St
Artesia, CA 90701-6628

Phone

(562) 924-4401

NPI assigned

May 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Namgu Kim DMD Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • West Covina, CA
  • NPI 1235002510
  NPD Authorized official
• Namgu Kim DMD Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
  • NPI 1316711245
  NPD Authorized official

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1821588039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 SCOTT CREEK DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985129036",
            "telephone_number": "503-686-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11635 SOUTH ST",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907016628",
            "telephone_number": "562-924-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11321 Scott Creek Dr SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985129036",
            "country_code": "US",
            "telephone_number": "503-686-4289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "NAMGU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "106535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice E Kim, DPM
• Hyoung Wook Kim, DDS
• Iljoon Kim, DMD
• John Sang Min Kim
• Kungsoo Kim, M.D.
• Roseann Knight
• Samuel Jinwook Ko, LIC, AC.
• Carole Kochi, D.C.
• Tahereh Korhani, D.D.S
• Jinwoo Kwak

• Orthodontics and Dentofacial Orthopedics Dentistry in Artesia, CA
• Providers in Artesia, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.