DR. SHIWOO KIM (NPI# 1255873345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255873345 |
| Entity Type | Individual |
| Full Name | DR. SHIWOO KIM |
| Credential | D.M.D |
| Practice Address |
1502 W Artesia Sq Apt B Gardena CA 90248-4761 |
| Practice Telephone | 2135905686 |
| Mailing Telephone | 2135905686 |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2016-11-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DDS100351 | CA | Dental Providers |
| Street Address |
1502 W ARTESIA SQ APT B |
| City | GARDENA |
| State | CA |
| Zip Code | 90248-4761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1154811297 | Patrick Lee | Technician/Technologist | 18203 S. Western Ave Ste. 102, Torrance, CA 90248 | 2018-05-15 |
| 1386152445 | Ariana Felicitas Nieves | Behavioral Analyst | 870 W 190th St Ste 400, Gardena, CA 90248 | 2018-01-11 |
| 1265949606 | Jessica Keller | Behavioral Analyst | 879 W 190th St Suite 400, Gardena, CA 90248 | 2018-01-08 |
| 1265941199 | Jaimee E Munson | Behavioral Analyst | 18726 S. Western Ave St, #408, Gardena, CA 90248 | 2017-09-22 |
| 1922467349 | Fred Jefferson Memorial Homes | Substance Abuse Rehabilitation Facility | 152 W. Walnut, Suite 150, Gardena, CA 90248 | 2016-02-12 |
| 1922427442 | Shana Reilly | Behavioral Analyst | 18726 S. Western Ave., Suite 408, Los Angeles, CA 90248 | 2014-04-11 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1093057598 | Aids Health Foundation | Pharmacist | 19300 S. Hamilton Ave., Ste 170, Gardena, CA 90248 | 2013-03-22 |
| 1245576594 | Hye Mi Kim | Behavioral Analyst | 18726 S. Western Ave.,#408, Gardena, CA 90248 | 2012-12-13 |
| Find all providers in zip 90248 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736513 | O.h. Barkhordar D.d.s.,inc. | Dentist | 1600 W Redondo Beach Blvd Ste 203, Gardena, CA 90247-3228 | 2020-10-08 |
| 1225645252 | Normandy Bay Joseph Dental Group | Dentist | 14011 Van Ness Ave, Gardena, CA 90249-2915 | 2020-09-24 |
| 1508426677 | Western Dental Services, Inc. | Dentist | 15515 Normandie Ave, Gardena, CA 90247-4013 | 2019-06-19 |
| 1730531666 | Christopher Yoo | Dentist | 1661 W 158th St # 204, Gardena, CA 90247-3890 | 2016-07-03 |
| 1407170996 | Marl Soon Chung | Dentist | 15622 S. Crenshaw Blvd #b, Gardena, CA 90249 | 2010-03-26 |
| 1649465121 | Syg Dental Corporation | Dentist | 1210 W Redondo Beach Blvd, Gardena, CA 90247-3411 | 2007-09-08 |
| 1104028505 | Mark Anthony Gerger | Dentist | 2235 W Rosecrans Ave, Gardena, CA 90249-2905 | 2007-06-05 |
| 1720298094 | Amir Saz | Dentist | 1104 W Redondo Beach Blvd, Gardena, CA 90247-3512 | 2007-05-23 |
| 1497967566 | Tae Sub Chung | Dentist | 15622 S Crenshaw Blvd, Ste B, Gardena, CA 90249-4528 | 2007-05-03 |
| 1982828562 | Yukinobu Tom Tomoda | Dentist | 15474 S Western Ave, Gardena, CA 90249-4325 | 2007-04-13 |
| Find all providers in GARDENA | ||||
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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.