AUDREY BORAHM KIM (NPI# 1386250355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386250355 |
| Entity Type | Individual |
| Full Name | AUDREY BORAHM KIM |
| Credential | DDS |
| Practice Address |
1st Dental Battalion/naval Dental Center Attn: Medical Staff Sves; Bldg 2238 A Ave Camp Pendleton CA 92055-5221 |
| Mailing Address |
56869 Antelope Trl Apt 6 Yucca Valley CA 92284-2871 |
| Practice Telephone | 8189391914 |
| Mailing Telephone | 8189391914 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
105474 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619456845 | Audrey Kim | Psychologist | 1156 High St, Santa Cruz, CA 95064-1077 | 2018-08-08 |
| 1831622687 | Audrey Kim | Student in an Organized Health Care Education/Training Program | 1400 S Coulter St, Suite 5100, Amarillo, TX 79106-1786 | 2017-04-09 |
| 1639305006 | Audrey Bena Kim | Acupuncturist | 15140 Ventura Blvd, Sherman Oaks, CA 91403-3343 | 2009-05-29 |
| 1164581807 | Audrey Yong-ah Kim | Pediatrics | 9400 Rosecrans Ave, Bellflower, CA 90706-2246 | 2006-12-08 |
| Street Address |
1ST DENTAL BATTALION/NAVAL DENTAL CENTER ATTN: MEDICAL STAFF SVES; BLDG 2238 A AVE |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055-5221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| 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 |
|---|---|---|---|---|
| 1558687889 | Lesley Ann Sacramento | Dentist | Ndc Building 13128, 1st Dental Battalion, Camp Pendleton, CA 92055-5221 | 2010-04-12 |
| 1891029955 | Brian Paul Jardina | Dentist | 1st Denbn/ndc, Building 13128, Camp Pendleton, CA 92055 | 2009-09-22 |
| 1174713432 | Kristina Lee Phillips | Dentist | Naval Hosptial, Camp Pendleton, Bldg H100, Santa Margarita Road, Camp Pendleton, CA 92055 | 2007-08-01 |
| 1831236470 | Jerry Willis Hamlin Jr. | Dentist | First Dental Battalion Ndc, Building 13128, Camp Pendleton, CA 92055-5221 | 2007-01-31 |
| 1346322542 | Son Phi Nguyen | Dentist | Building 1377 Area 13, Camp Pendleton, CA 92055 | 2006-10-19 |
| 1063593572 | Irma Louise Welch | Dentist | Las Flores Dental Clinic, 41 Area, Bldg. 414006, Camp Pendleton, CA 92055 | 2006-10-18 |
| 1497726194 | Elissa Joy Mcrae | Dentist | 1st Dental Batallion Ndc, Camp Pendleton, CA 92055-5221 | 2006-01-30 |
| 1609852078 | Chales Anthony Arena | Dentist | Box 555221, 1st Denbn/ndc, Camp Pendleton, CA 92055-5221 | 2005-12-19 |
| 1154305605 | Joshua C Treesh | Dentist | Hospital Dentistry, 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2005-11-29 |
| 1144219452 | Darryl Lynn Taylor | Dentist | 1st Dental Battalion, Naval Dental Center, Camp Pendleton Marine Base, Camp Pendleton, CA 92055-5221 | 2005-10-19 |
| Find all providers in CAMP PENDLETON | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
Please comment or provide details below to improve the information on AUDREY BORAHM KIM.
| 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.