Heoijin Kim, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DDS109935 Issued in CA

Practice address

1701 W Imperial Hwy Ste B
La Habra, CA 90631-0604

Phone

(562) 690-5729

NPI assigned

Feb 5, 2021

Last updated

May 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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.

• Heoijin Kim DDS Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
  • NPI 1396637120
  NPD Authorized official
• Noor Rahimi Dental Corporation

  dba La Habra Modern Dentistry

  • General Practice Dentistry
  • La Habra, CA
  • NPI 1407158223
  NPD (past)

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1912599457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 WILSHIRE BLVD APT 1109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103942",
            "telephone_number": "718-757-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W IMPERIAL HWY STE B",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906310604",
            "telephone_number": "562-690-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEOIJIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7566",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS109935",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eun Hee Kim, L.AC
• Hae Suk Kim, DDS
• Haeeun Kim, ASSOCIATE'S DEGREES
• Hanna Kim, PHARM.D
• Harrison Jongku Kim, L.AC.
• Howard Kim, DDS
• Hyejin Kim, ACUPUNCTURIST
• Il Hwan Kim
• Inn Hwa Kim
• Jason Kim

• Orthodontics and Dentofacial Orthopedics Dentistry in La Habra, CA
• Providers in La Habra, 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 May 7, 2024; 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.