Kyo Sung Kim, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

48485 Issued in CA

Practice address

3700 Wilshire Blvd Ste 780
Los Angeles, CA 90010-3001

Phone

(213) 380-7900

Fax

(213) 380-7900

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Han, Jang, Son & Suh, Dental Group, PC

  dba Wilshire Park Dental Group

  • Periodontics
  • Los Angeles, CA
  • NPI 1275781932

  Orthodontics and Dentofacial Orthopedics

  NPD (past)
• WPD Dental Group

  • Periodontics
  • Los Angeles, CA
  • NPI 1982002002
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881758894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11247 WAREHAM CT",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544875",
            "telephone_number": "909-799-9889",
            "fax_number": "909-799-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WILSHIRE BLVD STE 780",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103001",
            "telephone_number": "213-380-7900",
            "fax_number": "213-380-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYO",
        "middle_name": "SUNG",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "48485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klara Kim, PHARMD
• Kristi Kim
• Kwang E Kim, D.C.
• Kwang Hun Kim, ACUPUNCTURIST
• Kwangsoon Kim, L. AC.
• Kyong Tai Kim, PEER EMPL SPECIALIST
• Kyoung Ae Kim, MD
• Kyoung Chol Kim, MD
• Kyoungjun Kim, PH.D.
• Kyu Min Kim

• Orthodontics and Dentofacial Orthopedics Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• 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.