Stephen Chung Kim, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

51485 Issued in CA

Practice address

3811 Bedford Canyon Rd Ste 105
Corona, CA 92883-0789

Phone

(951) 270-0211

Fax

(951) 270-0702

NPI assigned

Jan 29, 2009

Last updated

Dec 6, 2017By 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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Sang C Paik DDS

  • Dentist
  • Corona, CA
  • NPI 1497979280
  NPD (past)
• Wong & Pham DDS, Inc.

  dba Eagle Glen Dental Group

  • General Practice Dentistry
  • Corona, CA
  • NPI 1417128034
  NPD (past)

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1881832806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 BEDFORD CANYON RD STE 105",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928830789",
            "telephone_number": "951-270-0211",
            "fax_number": "951-270-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 BEDFORD CANYON RD STE 105",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928830789",
            "telephone_number": "951-270-0211",
            "fax_number": "951-270-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEPHEN",
        "middle_name": "CHUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Kim, PHARMD
• Richard Joon Kim, PHARMD
• Sean Yoosin Kim, PT, DPT
• Sharon Kim, DC
• Stella Jin Kim, M.D.
• Sung Soo Kim, PHARMACIST
• Yoon Hoon Kim, MD
• Martin Karathi Kimani, RN
• Jeff Scott Kimball
• Kayana Elise Kincaid

• Orthodontics and Dentofacial Orthopedics Dentistry in Corona, CA
• Providers in Corona, 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 Dec 6, 2017; 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.