John Kim DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34860 Issued in CA

Legal business name

JOHN KIM DDS, INC

Practice address

906 N. Vermont Ave.
Los Angeles, CA 90029-3915

Phone

(323) 522-3382

Fax

(323) 934-4787

NPI assigned

Dec 29, 2011

Organization subpart

No

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

Authorized official

Name

Johnny K Kim

Title

Owner

Phone

(323) 617-4180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1831468362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 CRENSHAW BLVD #100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191957",
            "telephone_number": "323-617-4180",
            "fax_number": "323-617-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N. VERMONT AVE.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293915",
            "telephone_number": "323-522-3382",
            "fax_number": "323-934-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KIM DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-617-4180"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.