RICK TAE KIM (NPI# 1124156427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124156427 |
| Entity Type | Individual |
| Full Name | RICK TAE KIM |
| Credential | DDS |
| Practice Address |
21012 Norwalk Blvd Lakewood CA 90715-1503 |
| Mailing Address |
13249 Beach St Cerritos CA 90703-1329 |
| Practice Telephone | 5628608828 |
| Practice Fax Number | 5628690444 |
| Mailing Telephone | 5629218093 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
48622 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTI-CAL | G92417-01 | 01 |
| CA | DENTI-CAL | G92789-01 | 01 |
| Street Address |
21012 NORWALK BLVD |
| City | LAKEWOOD |
| State | CA |
| Zip Code | 90715-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457548182 | Rick T Kim A Professional Dental Corp | Dentist | 21012 Norwalk Blvd, Lakewood, CA 90715-1503 | 2007-09-26 |
| 1497875041 | Haejean Lee | Dentist | 21012 Norwalk Blvd, Lakewood, CA 90715-1503 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437510674 | Katie Perez | Technician, Other | 11907 205 St, Lakewood, CA 90715 | 2016-03-16 |
| 1699171504 | Amanda N Mcginnis | Dental Hygienist | 21001 Dalaman Ave, Lakewood, CA 90715 | 2014-11-05 |
| 1356458020 | Ellen L Chen | Dentist | 20147 S Pioneer Blvd, Lakewood, CA 90715 | 2006-08-25 |
| 1407012958 | Suraiya Motala | Student in an Organized Health Care Education/Training Program | 20215 Village Green Dr, Lakewood, CA 90715-1010 | 2008-08-04 |
| 1881250009 | Jennifer Roche-sheets | Counselor | 20133 Jersey Ave, Lakewood, CA 90715-1047 | 2019-05-13 |
| 1285766253 | Woosung Ahn, M.d., Inc | Internal Medicine | 20145 Pioneer Blvd, Lakewood, CA 90715-1051 | 2007-03-12 |
| 1396807806 | Woo Sung Ahn | Internal Medicine | 20145 S Pioneer Blvd, Lakewood, CA 90715-1051 | 2006-12-14 |
| 1881754489 | Candice Yee Chen | Dentist | 20147 Pioneer Blvd, Lakewood, CA 90715-1051 | 2006-12-12 |
| 1972515195 | Younghae Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 20141 Pioneer Blvd, Lakewood, CA 90715-1051 | 2006-08-13 |
| 1114942711 | Ralphs Grocery Company | Durable Medical Equipment & Medical Supplies | 20137 Pioneer Blvd, Lakewood, CA 90715-1051 | 2006-07-13 |
| Find all providers in zip 90715 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699386706 | Westgate Family Dentistry | Dentist | 2323 S Wadsworth Blvd Ste 109, Lakewood, CO 80227-3254 | 2020-08-12 |
| 1467076034 | Cornelius Joseph Osullivan | Dentist | 13616 Madison Ave, Lakewood, OH 44107-4709 | 2020-05-30 |
| 1245870336 | My Local Colorado Dental Practice, LLC | Dentist | 264 Union Blvd Ste 200, Lakewood, CO 80228-1970 | 2020-01-07 |
| 1265082366 | Leong and Pandhoh Dental Corporation | Dentist | 2710 Carson St, Lakewood, CA 90712-4051 | 2019-09-19 |
| 1598319550 | Golnaz Sadat Samimifar | Dentist | 325 S Teller St Ste 280, Lakewood, CO 80226-7389 | 2019-07-29 |
| 1861044232 | Bryce Jeffrey Plancich | Dentist | 5726 100th St Sw, Lakewood, WA 98499-2730 | 2019-07-15 |
| 1578122628 | Marc Joseph Salme | Dentist | 386 E Fairmount Ave, Lakewood, NY 14750-2130 | 2019-06-12 |
| 1376023101 | Edward J Wang | Dentist | 5606 Lakewood Towne Center Blvd Sw Ste B, Lakewood, WA 98499-3894 | 2018-08-21 |
| 1740649839 | Justin Ford Becerra | Dentist | 2323 S Wadsworth Blvd Ste 1778, Lakewood, CO 80227-3274 | 2016-02-17 |
| 1740657378 | Timothy M. Schroeder Dds | Dentist | 6565 W Jewell Ave Ste 3, Lakewood, CO 80232-7102 | 2015-08-31 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.