LOUIS M KIM, A PROFESSIONAL DENTAL CORPORATION (NPI# 1104336478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104336478 |
| Entity Type | Organization |
| Organization Name | LOUIS M KIM, A PROFESSIONAL DENTAL CORPORATION |
| Practice Address |
1824 Avondale Ave Sacramento CA 95825-1378 |
| Practice Telephone | 9169008521 |
| Practice Fax Number | 9169008526 |
| Mailing Telephone | 9169008521 |
| Mailing Fax Number | 9169008526 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | LOUIS KIM (OWNER/DENTIST) |
| Authorized Official Telephone | 9169008521 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUIS KIM DDS INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
53231 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1174711522 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3811 Florin Rd Ste 8, Sacramento, CA 958231818 | 9163927020 | 9163927048 |
| Street Address |
1824 AVONDALE AVE |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95825-1378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1962009308 | Andrea Isabel Morales | Behavior Technician | 333 University Avenue, Suite 200, Sacramento, CA 95825 | 2020-10-08 |
| 1942810510 | Melissa Marlene Lowndes | Occupational Therapist | 1337 Howe Ave Unit 107, Sacramento, CA 95825 | 2020-08-07 |
| 1780294827 | Travis Elliott Peppers | Case Manager/Care Coordinator | 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 | 2020-08-04 |
| 1154950327 | Hallie Wenz | Behavior Technician | 333 University Ave Suite #200, Sacramento, CA 95825 | 2020-04-08 |
| 1679105456 | Dr. Page Hudson Dental Corporation | Dentist | 1580 Howe Avenue, Suite A, Sacramento, CA 95825 | 2020-02-10 |
| 1710517891 | Amelia Garnica | Community/Behavioral Health | 720 Howe Avenue, Suite 102, Sacamento, CA 95825 | 2020-01-17 |
| 1427697374 | Anthony Barnes | Social Worker | 2008 Morse Avenue, Commons Building, Sacramento, CA 95825 | 2019-12-24 |
| 1528604519 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave., Suite 102, Cacramento, CA 95825 | 2019-11-25 |
| 1164068144 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave. Suite, 102, Sacramento, CA 95825 | 2019-11-25 |
| Find all providers in zip 95825 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434396 | Donald E. Clarke, Dds, Inc. | Clinic/Center | 930 Florin Rd Ste 104, Sacramento, CA 95831-5002 | 2020-10-12 |
| 1619599529 | Us Dental Care | Clinic/Center | 1901 Watt Ave Ste 4, Sacramento, CA 95825-2152 | 2020-05-13 |
| 1104484807 | Health and Life Organization, Inc. | Clinic/Center | 7275 E Southgate Dr Ste 106, Sacramento, CA 95823-2610 | 2019-05-29 |
| 1013488931 | Webber Dental Group, Inc | Clinic/Center | 905 Secret River Dr Ste A, Sacramento, CA 95831-3437 | 2018-12-17 |
| 1790263887 | Jordan Gaddis D.d.s. A Professional Dental Corporation | Clinic/Center | 2835 Eastern Ave Ste 3, Sacramento, CA 95821-5400 | 2018-08-01 |
| 1326403544 | Lawrence Lau, Dmd, PC | Clinic/Center | 8848 Calvine Rd, Suite 120, Sacramento, CA 95828-9334 | 2015-12-16 |
| 1023445335 | Arthur A. L. Burbridge Dds Inc. | Clinic/Center | 7485 Rush River Dr, Suite 755, Sacramento, CA 95831-5259 | 2013-10-01 |
| 1477993376 | Brenda Ho, Dds, Inc. | Clinic/Center | 905 Secret River Drive, Suite E, Sacramento, CA 95831 | 2013-06-25 |
| 1821357492 | Wellspace Health | Clinic/Center | 8231 E Stockton Blvd, Suite C, Sacramento, CA 95828-8202 | 2012-05-16 |
| 1346423316 | Melvin W. Walters, Dds - A Dental Corporation | Clinic/Center | 4450 Duckhorn Dr Ste B, Sacramento, CA 95834-2589 | 2007-12-12 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95825 |
Please comment or provide details below to improve the information on LOUIS M KIM, A PROFESSIONAL DENTAL CORPORATION.
| 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.