Youngchan Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110680 Issued in CA

Practice address

3790 N Blackstone Ave
Fresno, CA 93726-5306

Phone

(559) 225-5437

NPI assigned

Sep 2, 2024

Sex

Male

Sole proprietor

No

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": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1922833888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10059",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933890059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265306",
            "telephone_number": "559-225-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNGCHAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Eun Young Kim
• Vivian Y Kim, M.D.
• William Taewoo Kim, MD
• Yang J Kim, MD
• Yoon C Kim, RPH
• Kathleen Ann Kimball, FNP
• Daniel Kimble, LMFT
• Yuka Kimoto
• Linda Thanh Kimura, PHARM D
• Sharon Akiko Kimura, NP

• General Practice Dentistry in Fresno, CA
• Providers in Fresno, 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 Sep 2, 2024; 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.