Kim Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KIM DENTAL CORPORATION

Practice address

930 Sunnyslope Rd Ste B3
Hollister, CA 95023-5616

Phone

(831) 637-4627

NPI assigned

Aug 9, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Audrey Kim, DDSNPI 1053667832

Title

President

Phone

(716) 374-3273

Specialties & licenses 1

Addresses

Other names 1

• Family Dental and Implant Center Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Audrey Kim, DDS

  • Dentist
  • Hollister, CA
  • NPI 1053667832
  NPD Authorized official
• Gregory Paul Newton, DDS

  • Dentist
  • Hollister, CA
  • NPI 1679254940
  NPD
• Mark Leroy Stephens, D.D.S.

  • General Practice Dentistry
  • Hollister, CA
  • NPI 1750588174
  NPD (past)

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1922773365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17775 CALLE GRANADA",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950372992",
            "telephone_number": "716-374-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SUNNYSLOPE RD STE B3",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235616",
            "telephone_number": "831-637-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-374-3273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental and Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth P. Jiang Inc
• Kenneth P. Jiang MD, Inc
• Kenneth P. Jiang, M.D., Inc.
• Dilshad M. Kheraj, D.O.
• Khoi Le, D.D.S Inc.
• Audrey Kim, DDS
• Sheila Kimura, MFT
• Dustin Kinsley
• Kathleen Sue Kirk
• Lauren Jean Kissner, M.D.

• Dental Clinic/Center in Hollister, CA
• Providers in Hollister, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.