Yang H Kim, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48481 Issued in CA

Practice address

17736 San Bernardino Ave.
Fontana, CA 92335-0000

Phone

(909) 822-4363

Fax

(909) 822-4476

NPI assigned

Nov 20, 2006

Sex

Male

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

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

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1902970783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17736 SAN BERNARDINO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356133",
            "telephone_number": "909-822-4363",
            "fax_number": "909-822-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17736 SAN BERNARDINO AVE.",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350000",
            "telephone_number": "909-822-4363",
            "fax_number": "909-822-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YANG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Kim, PHARM.D.
• Paul B. Kim, MD
• Sam K. Kim, MD
• Sang Woo Kim, L.AC.
• Seung Bin Kim, PHARM.D.
• Young Kim
• Young Kwun Kim, D.D.S.
• Christina Kinney
• Jane Wambui Kinyanjui, LVN
• Ravi Veeramasuneni Kiran, MD

• General Practice Dentistry in Fontana, CA
• Providers in Fontana, 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 Mar 12, 2010; 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.