David Joon Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

64139 Issued in CA

Practice address

19333 Bear Valley Rd Ste 205
Apple Valley, CA 92308-5150

Phone

(760) 247-4155

Fax

(760) 247-4955

NPI assigned

Jan 13, 2015

Last updated

Jan 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1841689932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19333 BEAR VALLEY RD STE 205",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923085150",
            "telephone_number": "760-247-4155",
            "fax_number": "760-247-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19333 BEAR VALLEY RD STE 205",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923085150",
            "telephone_number": "760-247-4155",
            "fax_number": "760-247-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "JOON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khoi N Nguyen, Inc
• Yazan Khoury
• Anjit Khurana, MD
• Kids 1St Pediatrics, Inc.
• Violet Kigoonya, FNP
• Hanna Kim, LMFT
• Namjin Austin Kim, DC
• Nari Kim
• Samuel I Kim, D.D.S.
• Timothy Sungman Kim, PHARMD

• Dentist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.