James H Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47917 Issued in CA

Practice address

569 Bonanza Trail
Big Bear Lake, CA 92315

Phone

(909) 866-0606

NPI assigned

Mar 22, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 16, 2016 through May 16, 2028

Medicare enrollment (NPD)

Not 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.

• James Kim DDS a Professional Dental Corporation

  • General Practice Dentistry
  • Big Bear Lake, CA
  • NPI 1508038308
  NPD (past) Authorized official
• Ra and Kim Dental Corp

  • Dentist
  • Big Bear Lake, CA
  • NPI 1457476137
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1982720751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6951",
            "address_2": "42002 FOX FARM ROAD #101",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923156951",
            "telephone_number": "909-866-0606",
            "fax_number": "909-866-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 BONANZA TRAIL",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "92315",
            "telephone_number": "909-866-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAMES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jae Hwi Kang
• Chimwemwe Kawonga
• Paula Frankie Kennedy
• Sherin Kershah
• Gene Webster Kessinger Jr.
• Bobbye Klempin
• Steven Michael Knapik, D.O.
• Sara L. Kossuth, D.O.
• Kara Krueger
• Katrina Laframboise

• General Practice Dentistry in Big Bear Lake, CA
• Providers in Big Bear Lake, 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 Jun 30, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.