DR. TERI LY KIM (NPI# 1386721736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386721736 |
| Entity Type | Individual |
| Full Name | DR. TERI LY KIM |
| Credential | DDS |
| Practice Address |
747 52nd St. Oakland CA 94609 |
| Mailing Address |
P.o. Box 22210 Oakland CA 94623-2210 |
| Practice Telephone | 5109640168 |
| Mailing Telephone | 5105354000 |
| Mailing Fax Number | 5105354128 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
55811 | CA | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
13802 | MD | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932224433 | Teri Yae Sul Kim | Family Medicine | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2007-03-21 |
| Street Address |
747 52ND ST. |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033244058 | D. Jeanette Nichols | Registered Nurse | 747 52nd St., Oakland, CA 94609 | 2007-02-22 |
| 1366589558 | Susan Sweeny Hilk | General Acute Care Hospital | 747 52nd St., Children's Hospital Oakland, Oakland, CA 94609 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487090338 | Oakland Smile Station | Dentist | 9 Post Rd Ste M1a, Oakland, NJ 07436-1615 | 2013-05-20 |
| 1932487089 | Miller Dental Health | Dentist | 14710 Highway 194, Oakland, TN 38060-4134 | 2011-07-22 |
| 1063631109 | F Moftakhar Dds A Professional Corp | Dentist | 3301 E 12th St Ste 163, Oakland, CA 94601-2939 | 2007-04-25 |
| 1962547836 | Marvin Lagstein D M D P A | Dentist | 9 Post Road, Suite M1a Longhill Medical Dental Center, Oakland, NJ 07436 | 2007-02-20 |
| 1871667063 | Robert Wayne Aubuchon | Dentist | 3320 Webster Street, Oakland, CA 94609 | 2006-11-20 |
| 1275531816 | Denise Bass Allen | Dentist | 2100 Broadway, Oakland, CA 94612-2310 | 2005-07-08 |
| 1598135642 | Vishavjeet Girn | Dentist | 3050 E 16th St, Oakland, CA 94601-2319 | 2015-10-01 |
| 1205250081 | Michael Suh | Dentist | 4881 Telegraph Ave, Oakland, CA 94609-2009 | 2014-02-13 |
| 1811319841 | Malay Mathur | Dentist | 2950 International Blvd, Oakland, CA 94601-2228 | 2014-01-10 |
| 1891830378 | Karen Taniguchi Ching | Dentist | 345 9th St, Suite 302, Oakland, CA 94607-6522 | 2007-02-21 |
| Find all providers in OAKLAND | ||||
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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.