Individual provider Active NPI

Christine H. Kim, D.D.S.

  • Dentist
  • Huntington Beach, CA
National Provider Identifier
1861600603
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46278 Issued in CA
Practice address
17752 Beach Blvd Ste 301
Huntington Beach, CA 92647-6808
Phone
(714) 848-1851
Fax
(714) 848-1691
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46278 CA Primary

Addresses

Primary practice location

17752 Beach Blvd Ste 301
Huntington Beach, CA 92647-6808

Mailing address

17752 Beach Blvd Ste 301
Huntington Beach, CA 92647-6808
Phone (714) 848-1851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46278CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861600603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17752 BEACH BLVD STE 301",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476808",
            "telephone_number": "714-848-1851",
            "fax_number": "714-848-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17752 BEACH BLVD STE 301",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476808",
            "telephone_number": "714-848-1851",
            "fax_number": "714-848-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTINE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.