Diana Hyun Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103385 Issued in CA

Practice address

9450 Fairway Dr Ste 110
Roseville, CA 95678-3588

Phone

(916) 740-1166

NPI assigned

Dec 17, 2009

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1881923027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 FANTAIL LN",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487813",
            "telephone_number": "360-265-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 FAIRWAY DR STE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956783588",
            "telephone_number": "916-740-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2310 Craven St",
            "address_2": "NMCSD Naval Branch Clinic",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921365596",
            "country_code": "US",
            "telephone_number": "619-556-9193",
            "fax_number": "619-556-9410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DIANA",
        "middle_name": "HYUN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinn Killingsworth
• Lisa Kim-Fisher
• Bonnie Kim
• Da Hee Kim, AMFT
• Daniel Kim
• Don Han Kim, DDS, MD
• Eric Kim, PHARMD
• Esther Hyeun Kim, PA-C
• Go Eun Kim, DMD, MS
• Ina Kim, MD

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.