SAMUEL KIM DDS INC (NPI# 1073708202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073708202 |
| Entity Type | Organization |
| Organization Name | SAMUEL KIM DDS INC |
| Other Organization Name | APPLE VALLEY DENTAL |
| Practice Address |
21580 Bear Valley Rd Ste B2-2 Apple Valley CA 92308-7200 |
| Practice Telephone | 7602476007 |
| Mailing Telephone | 7602476007 |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |
| Authorized Official Name | DR. SAMUEL KIM (OWNER) |
| Authorized Official Telephone | 7602476007 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 51348 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Apple Valley Dental | Doing Business As Name - Organization |
| Street Address |
21580 BEAR VALLEY RD STE B2-2 |
| City | APPLE VALLEY |
| State | CA |
| Zip Code | 92308-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144831850 | Lisa K Frandsen | Behavioral Analyst | 19794 Poppy Rd, Apple Valley, CA 92308 | 2020-08-14 |
| 1518484195 | Jennifer Redwine | Behavioral Analyst | 1905 Business Center Drive South, Unit 100, San Bernardino, CA 92308 | 2017-08-24 |
| 1508397100 | West Care Transportation | Non-emergency Medical Transport (VAN) | 15480 Straight Arrow Rd #b, Apple Valley, CA 92308 | 2017-03-24 |
| 1811346497 | E Kim Dental Corp | Dentist | 21580 Bear Valley Rd., Ste B2-2, Apple Valley, CA 92308 | 2016-06-06 |
| 1134575376 | Seth Owuor | Pharmacist | 14426 Palmdale Road, Victorville, CA 92308 | 2016-05-06 |
| 1043608763 | Kamal Ebadpour | Adult Companion | 13224 Iroquois Road, Apple Valley, CA 92308 | 2015-01-05 |
| 1487099669 | Hateem Siddiqui | Internal Medicine | 19059 Bear Valley Rd # 3, Apple Valley, CA 92308 | 2013-05-01 |
| 1225305618 | Edward N. Sianipar | Nurse Practitioner | 19059 Bear Valley Rd., #1, Apple Valley, CA 92308 | 2011-11-29 |
| 1043508559 | Southern California Primary Medical Inc | Clinic/Center | 19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308 | 2011-07-18 |
| 1396070959 | Asghar Ali Rajani | Registered Nurse | 19059 Bear Valley Road, Apple Valley, CA 92308 | 2009-10-14 |
| Find all providers in zip 92308 | ||||
| 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 |
|---|---|---|---|---|
| 1134578826 | Ellen Denise Jacobson | Dentist | 14682 Pennock Avenue South, Apple Valley, MN 55124 | 2016-06-03 |
| 1841689932 | David Joon Kim | Dentist | 19333 Bear Valley Rd Ste 205, Apple Valley, CA 92308-5150 | 2015-01-13 |
| 1720485618 | Sun Choi | Dentist | 20162 Us Highway 18, Apple Valley, CA 92307-2935 | 2014-11-20 |
| 1962781898 | Nicholas Patrick Navarro | Dentist | 14600 Granada Dr, Apple Valley, MN 55124-7419 | 2011-08-09 |
| 1104126168 | Charles N Miller Dds Pa | Dentist | 7631 145th St W, Apple Valley, MN 55124-5511 | 2010-10-25 |
| 1659506558 | Haisam Sayed, Dds Inc. | Dentist | 18805 Bear Valley Road, Suite 4, Apple Valley, CA 92308-6709 | 2009-05-20 |
| 1811133325 | Bashar Suleiman Ayyoub | Dentist | 19071 Bear Valley Rd, Suite 1, Apple Valley, CA 92308-2718 | 2009-01-05 |
| 1407011448 | Robert John Whiting | Dentist | 16127 Kasota Rd Ste 103, Apple Valley, CA 92307-2204 | 2008-07-18 |
| 1205004124 | Western Dental Services, Inc | Dentist | 19071 Bear Valley Rd., Suite #1, Apple Valley, CA 92308-6709 | 2008-02-13 |
| 1740466283 | Rashmi J Shankar | Dentist | 19276 Monterey St, Apple Valley, CA 92308-6097 | 2008-01-15 |
| Find all providers in APPLE VALLEY | ||||
| City | APPLE VALLEY |
| Zip Code | 92308 |
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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.