CHARLES KIM DENTAL CORPORATION (NPI# 1396344073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396344073 |
| Entity Type | Organization |
| Organization Name | CHARLES KIM DENTAL CORPORATION |
| Practice Address |
15651 Imperial Hwy Ste 204 La Mirada CA 90638-1653 |
| Practice Telephone | 5629433794 |
| Mailing Telephone | 5629433794 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | CHARLES KIM (OWNER DENTIST) |
| Authorized Official Telephone | 5629433794 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
15651 IMPERIAL HWY STE 204 |
| City | LA MIRADA |
| State | CA |
| Zip Code | 90638-1653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972144095 | Amanda Connell | Counselor | 13710 La Mirada Blvd., Straight Talk, La Mirada, CA 90638 | 2019-09-30 |
| 1679054894 | James Kim | Occupational Therapist | 11926 La Mirada Blvd., La Mirada, CA 90638 | 2018-08-25 |
| 1780163915 | Complete Spine and Joint Center Inc | Chiropractor | 15112 Rosecrans Ave, La Mirada, CA 90638 | 2018-08-08 |
| 1124520606 | Meredith Narcisse | Counselor | Aegis Treatment Center 14240 Imperial Hwy, La Mirida, CA 90638 | 2018-03-01 |
| 1336685114 | Dorina Hamilton | Counselor | 14240 E. Imperial Hwy., La Mirada, CA 90638 | 2017-01-17 |
| 1497201768 | Blm Pharmacy Inc | Pharmacy | 12675 La Mirada Blvd., Suite 100, La Mirada, CA 90638 | 2016-08-28 |
| 1972954535 | Wendy Tran | Dentist | 12265 La Mirada Blvd, La Mirada, CA 90638 | 2016-06-24 |
| 1962851410 | Amy Bender | Counselor | 14240 Imperial Highway, La Mirada, CA 90638 | 2016-06-06 |
| 1699137430 | Andrea Lauren Smith | Chiropractor | 15651 East Imperial Hwy Ste 100, La Mirada, CA 90638 | 2016-03-22 |
| 1750797098 | Napoleon Tiquia | General Practice | 12049 Hartdale Avenue, La Mirada, CA 90638 | 2014-07-08 |
| Find all providers in zip 90638 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184233538 | Sung Wook Park Dds Inc. | Clinic/Center | 14930 Imperial Hwy Ste D, La Mirada, CA 90638-2100 | 2020-07-30 |
| 1922646827 | Byun and Patel Dds Inc | Clinic/Center | 15072 Rosecrans Ave, La Mirada, CA 90638-4740 | 2019-12-11 |
| 1760661243 | Ming-ya Chwu Dds Inc | Clinic/Center | 15651 Imperial Hwy, Suite 201a, La Mirada, CA 90638-1628 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093551 | Arshdeep Kaur Dental Corporation | Clinic/Center | 345 F St Ste 180, Chula Vista, CA 91910-2648 | 2020-11-08 |
| 1699376350 | Funto Ayanleke Dds | Clinic/Center | 1116 W Tokay St Ste A, Lodi, CA 95240-3852 | 2020-11-07 |
| 1427658541 | Anthony Ngo, Dmd Professional Corporation | Clinic/Center | 18361 Beach Blvd, Huntington Beach, CA 92648-1310 | 2020-10-28 |
| 1912507948 | Alexander Phillips Dds Inc | Clinic/Center | 120 C Ave Ste 100, Coronado, CA 92118-1992 | 2020-10-28 |
| 1912507203 | George K Nguyen Dds, PC | Clinic/Center | 2097 Compton Ave Ste 104, Corona, CA 92881-7289 | 2020-10-27 |
| 1316547524 | Ingersoll Park Marina Gp Dental Corporation | Clinic/Center | 2301 Park Marina Dr Ste 27, Redding, CA 96001-2158 | 2020-10-27 |
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1760081129 | Anthony Pham Dental Corp | Clinic/Center | 2658 E Garvey Ave S, West Covina, CA 91791-2113 | 2020-10-17 |
| 1215535182 | Park and Park Dental Group Partnership | Clinic/Center | 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 | 2020-10-13 |
| 1013515196 | Bayrakdarian Tulare, D.m.d., Inc., A Professional Corporation | Clinic/Center | 1450 E Prosperity Ave, Tulare, CA 93274-8054 | 2020-10-12 |
| Find all providers with the same taxonomy | ||||
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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.