Kim & Kim Professional Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54775 Issued in CA

Legal business name

KIM & KIM PROFESSIONAL DENTAL CORP

Practice address

2300 W Pico Blvd
Suite 204
Los Angeles, CA 90006-4021

Phone

(213) 385-6919

NPI assigned

Aug 30, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Joowon Kim, D.D.S.

Title

President

Phone

(917) 842-3225

Specialties & licenses 2

Addresses

Other names 1

• Pico Vista Dental Doing business as

Locations

Practitioners 1

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

• Kyu Soo Kang, DDS

  • Dentist
  • La Palma, CA
  • NPI 1376758847
  NPD (past)

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1932533528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232019",
            "telephone_number": "714-778-6614",
            "fax_number": "562-402-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W PICO BLVD",
            "address_2": "SUITE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064021",
            "telephone_number": "213-385-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM & KIM PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOOWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-842-3225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54775",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pico Vista Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Killough
• Keith F. Killu, M.D.
• Rachel Kilpatrick, MPT
• Kilpyung Auh DDS a Professional Corporation
• Robert Andrew Kilroy, D.C.
• Kim and Tran Dental Corp
• Kim CHI Le
• Kim Chiropractic & Pain Management, Inc.
• Lindsay Yeonsoo Kim Choi
• Kim DDS a Dental Corp

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 30, 2013; 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.