Kwang Seob Kim DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KWANG SEOB KIM DDS INC

Doing business as

California Dental Group

Practice address

12309 Carson St
Hawaiian Gardens, CA 90716-1603

Phone

(562) 403-8818

Fax

(562) 403-1024

NPI assigned

Dec 21, 2018

Last updated

Jun 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kwang Seob Kim, DDS

Title

Dentist

Phone

(562) 403-8818

Specialties & licenses 1

Addresses

Other names 1

• California Dental Group Doing business as

Locations

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1851863393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12309 CARSON ST",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161603",
            "telephone_number": "562-403-8818",
            "fax_number": "562-403-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12309 CARSON ST",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161603",
            "telephone_number": "562-403-8818",
            "fax_number": "562-403-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANG SEOB KIM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KWANG",
        "authorized_official_middle_name": "SEOB",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "562-403-8818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keun Chan Lee DDS Inc
• Kristen Carolyn Killackey
• Tae Young Kim
• Young Rae Kim, D.D.S
• KND Development 53, L.L.C. (Kindred Hospital South Bay - Tri-City Campus)
• Gloria Cristina Lainez, MFT
• Yanina V Lambert
• Mayte Larios
• Chung Min Lee, MD
• Connery Lee, FNP

• Dental Clinic/Center in Hawaiian Gardens, CA
• Providers in Hawaiian Gardens, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.