Hayoung Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

109484 Issued in CA

Practice address

1705 S Mooney Blvd
Visalia, CA 93277-4445

Phone

(800) 400-3333

NPI assigned

Sep 19, 2023

Sex

Female

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

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

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.

• Usha Mantena Dental Corporation

  • Dentist
  • Vacaville, CA
  • NPI 1073976361
  NPD (past)
• Usha Mantena Dental Corporation

  • General Practice Dentistry
  • Vacaville, CA
  • NPI 1093176380
  NPD (past)

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1942088083",
    "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": "1705 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774445",
            "telephone_number": "800-400-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAYOUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylene Nichole Kierce, CNM
• David E Kilgore, MD
• Crystal Minhee Kim, O.D.
• Dean Daehyun Kim, D.D.S.
• Hannah Yejin Kim, MD
• Ji-Hyun Kim, DDS
• Jun Kim, D.O.
• Matthew Kim, M.D.
• Minji Kim, DMD
• Yale Kim

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.