Grace Kim Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

58445 Issued in CA

Legal business name

GRACE KIM DENTAL CORPORATION

Doing business as

iLove Dental Practice

Practice address

1770 S Barranca Ave
Glendora, CA 91740-5421

Phone

(626) 339-4600

Fax

(626) 339-4099

NPI assigned

Sep 17, 2015

Last updated

Sep 17, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Grace Mijin Kim, D.D.SNPI 1356641922

Title

President

Phone

(626) 339-4600

Specialties & licenses 1

Addresses

Other names 1

• iLove Dental Practice 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, and the practitioner matching its NPPES authorized official.

• Grace Mijin Kim, DDS

  • General Practice Dentistry
  • Glendora, CA
  • NPI 1356641922
  NPD (past) Authorized official

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1932578101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 S BARRANCA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405421",
            "telephone_number": "626-339-4600",
            "fax_number": "626-339-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 S BARRANCA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405421",
            "telephone_number": "626-339-4600",
            "fax_number": "626-339-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE KIM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "MIJIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-339-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iLove Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Esteban Gonzalez, REGISTERED NURSE
• Ruby Gonzalez, M.D.
• Donna Lynn Gordon, LCSW 29681
• Daniel E Gormley, MD
• Judith Goss
• Graceful Hospice Care Inc
• Wanda Lou Griffin, RN
• Judy Elizabeth Grover, LMFT
• Audrey Guentert, PTA
• Michelle Grace Reotutar Guerrero

• Dentist in Glendora, CA
• Providers in Glendora, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.