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MR. KWANG JIN KIM D.D.S NPI 1578611356


NPI Information

NPI: 1578611356
Provider Name: MR. KWANG JIN KIM, D.D.S
Classification: Dentist - 1223D0001X
Entity Type: Individual

Specialization: Dental Public Health

PECOS Registration: Yes

Address:
3300 W ROSECRANS AVE
SUITE 105
HAWTHORNE, CA
ZIP 90250
Phone: (310) 679-3300
Get Directions

MR. Kwang Jin Kim, D.D.S is a dental public health dentist in Hawthorne, CA. The provider is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. MR. Kwang Jin Kim, D.D.S NPI is 1578611356. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3300 W ROSECRANS AVE
SUITE 105
HAWTHORNE, CA
ZIP 90250-218
Phone: (310) 679-3300
Fax: (310) 679-3932

The NPI 1578611356 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/8/2007 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223D0001XDentistDental Public Health31300CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B-31300-02OTHERCALIFORNIAMEDICAL PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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