Organization Active NPI

Mma Dentist Inc

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1831904259
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MMA DENTIST INC
Practice address
229 N Central Ave
Glendale, CA 91203-3507
Phone
(747) 244-9553
NPI assigned
Feb 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Steve Min Kim, DDS
Title
Dentist
Phone
(747) 244-9553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

229 N Central Ave
Glendale, CA 91203-3507

Mailing address

229 N Central Ave
Glendale, CA 91203-3507
Phone (747) 244-9553

National Provider Directory

National Provider Directory

Locations

229 N Central Ave
Glendale, CA 91203
Phone (626) 825-1444

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1831904259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033507",
            "telephone_number": "747-244-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033507",
            "telephone_number": "747-244-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMA DENTIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "MIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "747-244-9553",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.