Jin Young Kim, D.D.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

54575 Issued in CA

Practice address

20657 Golden Springs Dr.
Ste. 205B
Diamond Bar, CA 91789-3837

Phone

(909) 859-8800

Fax

(909) 859-8753

NPI assigned

Oct 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Locations

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

• Jin Y Kim Dental Group Inc

  • Prosthodontics
  • Diamond Bar, CA
  • NPI 1871121707
  NPD Authorized official
• Jin Y. Kim DDS, Inc.

  • Prosthodontics
  • Garden Grove, CA
  • NPI 1063687937

  General Practice

  NPD Authorized official
• Jin Y. Kim DDS, Inc.

  • Prosthodontics
  • Garden Grove, CA
  • NPI 1639710973
  NPD Authorized official

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1922296623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20657 GOLDEN SPRINGS DR.",
            "address_2": "STE. 205B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917893837",
            "telephone_number": "909-859-8800",
            "fax_number": "909-859-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20657 GOLDEN SPRINGS DR.",
            "address_2": "STE. 205B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917893837",
            "telephone_number": "909-859-8800",
            "fax_number": "909-859-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN YOUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54575",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "54575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyosu Kim
• Hyung Ah Kim
• James Eui Dong Kim, RN
• Jeunghoan Kim, FNP-C
• Jin Y Kim, DDS, MPH, MS
• Jong Guhn Kim, M.D.,
• June Kim, ACUPUNCTURIST
• Jung Hyun Kim
• Keun Chul Kim
• Micah Kim, D.C.

• Prosthodontics in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Prosthodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.