KWANG SEOB KIM DDS INC (NPI# 1851863393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851863393 |
| Entity Type | Organization |
| Organization Name | KWANG SEOB KIM DDS INC |
| Other Organization Name | CALIFORNIA DENTAL GROUP |
| Practice Address |
12309 Carson St Hawaiian Gardens CA 90716-1603 |
| Practice Telephone | 5624038818 |
| Practice Fax Number | 5624031024 |
| Mailing Telephone | 5624038818 |
| Mailing Fax Number | 5624031024 |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2019-06-24 |
| Authorized Official Name | DR. KWANG SEOB KIM (DENTIST) |
| Authorized Official Telephone | 5624038818 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| California Dental Group | Doing Business As Name - Organization |
| Street Address |
12309 CARSON ST |
| City | HAWAIIAN GARDENS |
| State | CA |
| Zip Code | 90716-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053708081 | Pathway Medical Group | Specialist | 21500 S. Pioneer Blve Suite 210, Hawaiian Gardens, CA 90716 | 2015-04-16 |
| 1790032605 | Nancy Perez | Registered Nurse | 22009 Verne Ave, Hawaiian Gardens, CA 90716 | 2012-08-09 |
| 1194098210 | Ismael B. Nacino Md Inc | Anesthesiology | 21530 Pioneer Bl, Hawaiian Garden, CA 90716 | 2012-02-21 |
| 1326248832 | William Martin Wright | Counselor | 21520 S. Pioneer Blvd., Hawaiian Gardens, CA 90716 | 2007-07-23 |
| 1134341514 | Girish H Rami | Dentist | 12144 E Carson St, # E, Hawaiian Gardens, CA 90716 | 2007-05-03 |
| 1578684080 | Keun Chan Lee | Dentist | 12531 E Carson St, Hawaiian Gardens, CA 90716 | 2007-04-02 |
| 1154451995 | Consuelo Ramirez | Social Worker | 21520 S. Pioneer Bvld., Suite 110, Hawaiian Gardens, CA 90716 | 2007-03-07 |
| 1326102013 | Hyun Chan Lee | Dentist | 12137 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-20 |
| 1871656488 | Elena G Ezpeleta | Anesthesiology | 21530 South Pioneer Blvd, Hawaiian Gardens, CA 90716 | 2006-12-18 |
| 1144388687 | Jong Chul Han | Dentist | 11846 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-05 |
| Find all providers in zip 90716 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| 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 |
| 1396344073 | Charles Kim Dental Corporation | Clinic/Center | 15651 Imperial Hwy Ste 204, La Mirada, CA 90638-1653 | 2020-10-22 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | HAWAIIAN GARDENS |
| Zip Code | 90716 |
Please comment or provide details below to improve the information on KWANG SEOB KIM DDS INC.
| 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.