Youngbae Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48624 Issued in CA

Practice address

903 Crenshaw Blvd
#303
Los Angeles, CA 90019-1964

Phone

(323) 930-4800

Fax

(323) 930-4801

NPI assigned

Jul 1, 2008

Sex

Male

Sole proprietor

Yes

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

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.

• Young Bae Kim D.D.S Inc.

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1801215710
  NPD (past) Authorized official

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1962664862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 SOUTH CRENSHAW BLVD",
            "address_2": "#303",
            "city": "LA",
            "state": "CA",
            "postal_code": "90019",
            "telephone_number": "323-930-4800",
            "fax_number": "323-930-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD",
            "address_2": "#303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191964",
            "telephone_number": "323-930-4800",
            "fax_number": "323-930-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNGBAE",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Young O Kim, AC
• Young Sun Kim, MD
• Young Sun Kim, O.D.
• Young Tek Kim, L.AC
• Young Uk Kim, LAC
• Youngeun Kim, LMFT
• Youngin Kim, ACUPUNCTURE
• Youngkwang Kim, D.C
• Youngwook Kim, NP
• Yukyung Kristin Kim

• 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 May 10, 2016; 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.