Jin Kim Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

48484

Legal business name

JIN KIM DENTAL CORPORATION

Practice address

12190 Perris Blvd
Suite D
Moreno Valley, CA 92557

Phone

(951) 486-0550

NPI assigned

May 2, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jin Hyuk Kim, D.D.S.

Title

Ceo

Phone

(909) 363-6125

Specialties & licenses 1

Addresses

Other names 1

• Smile Dental Doing business as

Locations

Practitioners 2

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

• Yahya Sulieman Jaber, DDS

  • Dentist
  • Moreno Valley, CA
  • NPI 1427113927
  NPD (past)
• Dae Won Lee, DDS

  • General Practice Dentistry
  • Moreno Valley, CA
  • NPI 1750501540
  NPD (past)

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1972913655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12190 PERRIS BLVD",
            "address_2": "SUITE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92557",
            "telephone_number": "951-486-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12190 PERRIS BLVD",
            "address_2": "SUITE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92557",
            "telephone_number": "951-486-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIN KIM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JIN HYUK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-363-6125",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": "48484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Changmin Jiang, MASSAGE THERAPIST
• Jiloa Treatment and Recovery Centers Inc
• Eileen Jimenez
• Victoria Jimenez
• Xavier F Jimenez, RN, BSN
• Tejas Jivan, MD
• JL Pain Management Center Inc
• Daniel Joe, M.D.
• Deborah Louise Joe, MSW
• Joel a Pengson, MD, a Medical Corporation

• Dentist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.