Active NPI
Danielle Kim, DDS
- Dentist
- North Hollywood, CA
National Provider Identifier
1871361139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109526
- Practice address
- 11404 Victory Blvd
North Hollywood, CA 91606-3616 - Phone
- (818) 688-7655
- NPI assigned
- Dec 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109526 | CA | Primary |
Addresses
Primary practice location
11404 Victory Blvd
North Hollywood, CA 91606-3616
Mailing address
2631 Greenfield Ave
Los Angeles, CA 90064-3127
Phone (818) 632-0115
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109526 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1871361139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2631 GREENFIELD AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900643127",
"telephone_number": "818-632-0115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11404 VICTORY BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916063616",
"telephone_number": "818-688-7655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DANIELLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-18",
"last_updated": "2024-01-24",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.