Susie Kim DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

55016 Issued in CA

Legal business name

SUSIE KIM DDS, INC

Practice address

13345 Artesia Blvd
Cerritos, CA 90703-1316

Phone

(626) 244-9240

NPI assigned

May 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Susie M Kim, DDS

Title

President

Phone

(626) 244-9240

Specialties & licenses 1

Addresses

Other names 1

• Cerritos Dentistry Doing business as

Locations

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1962795294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13345 ARTESIA BLVD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13345 ARTESIA BLVD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031316",
            "telephone_number": "626-244-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSIE KIM DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-244-9240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cerritos Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.