Cynthia Tak, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

45327 Issued in CA

Practice address

69420 Ramon Rd
Cathedral City, CA 92234-3349

Phone

(760) 202-1171

Fax

(760) 202-1170

NPI assigned

Jul 30, 2014

Sex

Female

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dong Jin Kim, DDS, Inc

  • Dental Clinic/Center
  • Cathedral City, CA
  • NPI 1346658622
  NPD (past)

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1871901165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69420 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343349",
            "telephone_number": "760-202-1171",
            "fax_number": "760-202-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69420 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343349",
            "telephone_number": "760-202-1171",
            "fax_number": "760-202-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "CYNTHIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of California - Department of Developmental Services
• Patricia Stover
• Bruce Merlin Strathdee, DDS
• Sundance Comfort Living Inc.
• Buu-Anh CHI Ta, PHARMD
• Jigisha Tanna
• Kristin Noel Tapia
• Nicholas James Taylor, DPT
• Brandi Marie Teegarden, FNP
• Hanh Thai

• Dentist in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.