DR. KI WAN KIM (NPI# 1689961120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689961120 |
| Entity Type | Individual |
| Full Name | DR. KI WAN KIM |
| Credential | D.D.S. |
| Practice Address |
3601 Vista Way Suite #202 Oceanside CA 92056-4559 |
| Practice Telephone | 7604391871 |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2014-11-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
63507 | CA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356490734 | Ki Wan Kim | Surgery | 61 Whitcher St Ne Ste 4120, Marietta, GA 30060 | 2007-01-09 |
| Street Address |
3601 VISTA WAY SUITE #202 |
| City | OCEANSIDE |
| State | CA |
| Zip Code | 92056-4559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114904422 | Andres Zimmermann | Internal Medicine | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2005-12-28 |
| 1154613818 | Rady Children's Hospital - San Diego | Psychologist | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2011-05-12 |
| 1982856290 | Michelle Gonzales Md PC | Family Medicine | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2008-10-17 |
| 1528120748 | Wilson Liu | Family Medicine | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2006-12-14 |
| 1821173022 | Chad Burgess | Dentist | 3601 Vista Way, Suite 202, Oceanside, CA 92056-4559 | 2006-10-26 |
| 1073539136 | Michelle Gonzales | Family Medicine | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174148639 | Universal Health Net San Diego | Hospice Care, Community Based | 4155 Oceanside Blvd, Suite 240, Oceanside, CA 92056 | 2020-06-10 |
| 1750913216 | Jared Pomerenke | Counselor | 3923 Warning Rd., Suite D, Oceanside, CA 92056 | 2020-02-12 |
| 1700424728 | Donna Jean Trapolino | Dental Hygienist | Bldg414006 Nelson Rd, Camp Pendleton, CA 92056 | 2019-12-20 |
| 1679122717 | David King Ping | Registered Nurse | 3609 Ocean Ranch Blvd Street 104, Oceanside, CA 92056 | 2019-09-11 |
| 1396254058 | Alison Schurman | Nurse Practitioner | 200 Mercy Circle Dr, Department of Pediatrics, Oceanside, CA 92056 | 2017-09-26 |
| 1407212665 | Yolanda Orozco Gaeta | Marriage & Family Therapist | 3923 Waring Road Ste D, North Coastal Treatment Recovery Center, Oceanside, CA 92056 | 2016-01-04 |
| 1871982751 | Wael Wassef | Pharmacist | 4755 Oceanside Blvd Ste 130, Oceanside, CA 92056 | 2015-01-15 |
| 1639501869 | William Stacy Parks | Family Medicine | 2376 Back Nine St., Oceanside, CA 92056 | 2013-07-30 |
| 1760725766 | Great Expectations Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4825 Glenhaven Drive, Oceanside, CA 92056 | 2013-03-28 |
| 1649533993 | Justin Bowles | Family Medicine | 1761 Avenida Segovia, Oceanside, CA 92056 | 2012-06-21 |
| Find all providers in zip 92056 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699933416 | Gregory Michael Kusner | Dentist | 2741 W Vista Way, #103, Oceanside, CA 92054-6373 | 2008-05-29 |
| 1972522118 | Steven Mitchnick, Dmd PC | Dentist | 3051 Long Beach Rd Ste 7, Oceanside, NY 11572-3240 | 2006-07-19 |
| 1821173022 | Chad Burgess | Dentist | 3601 Vista Way, Suite 202, Oceanside, CA 92056-4559 | 2006-10-26 |
| 1205858545 | Steven Mitchnick | Dentist | 3051 Long Beach Rd Ste 7, Oceanside, NY 11572-3240 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578655 | Pinole Endodontics | Dentist | 2150 Appian Way Ste 207, Pinole, CA 94564-2520 | 2020-11-05 |
| 1518566702 | Sp Endodontics Partnershiop | Dentist | 1300 W Lodi Ave Ste N, Lodi, CA 95242-3038 | 2020-10-20 |
| 1215535661 | Ascella Justine Ronson | Dentist | 35395 Linda Rosea Rd, Temecula, CA 92592-9532 | 2020-10-16 |
| 1457964215 | Lars Bjorn Jonsson, D.d.s., M.s., Inc. | Dentist | 25261 Paseo De Valencia Ste 3, Laguna Hills, CA 92637-4966 | 2020-08-31 |
| 1952929333 | Noureldin Shoreibah Dds Inc | Dentist | 7677 Center Ave Ste 210, Huntington Beach, CA 92647-9103 | 2020-07-11 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1568091833 | M. Potti Dds Msd Inc | Dentist | 6400 Village Pkwy Ste 100, Dublin, CA 94568-3007 | 2020-04-07 |
| 1194356840 | Liang Dental Group Inc | Dentist | 5562 Philadelphia St Ste 211, Chino, CA 91710-2499 | 2020-01-31 |
| 1699313015 | Paul Erben Dmd Msd PC | Dentist | 937 E Main St Ste 204, Santa Maria, CA 93454-5309 | 2019-12-16 |
| 1396382495 | Narbeh Bandary Dental Corp | Dentist | 4910 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1718 | 2019-12-08 |
| 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.