MEDICARE: KIM & KIM PROFESSIONAL DENTAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	54886	CA
2	1223G0001X	General Practice Dentistry	54775	CA

General Provider Information

NPI Number	:	1932533528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIM & KIM PROFESSIONAL DENTAL CORP

Provider Business Mailing Address
First Line	:	4887 LA PALMA AVE
Second Line	:
City	:	LA PALMA
State	:	CA
Zip	:	90623-2019
Country	:	US
Telephone Number	:	714-778-6614
Fax Number	:	562-402-6377

Provider Business Practice Location Address
First Line	:	2300 W PICO BLVD
Second Line	:	SUITE 204
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4021
Country	:	US
Telephone Number	:	213-385-6919
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOOWON KIM
Credential	:	D.D.S.
Telephone Number	:	917-842-3225

Provider Enumeration Date	:	08/30/2013
Last Update Date	:	08/30/2013

Similar Medicare Providers

1093767105 — ANIL MOHIN MD, FACC A PROFESSIONAL MEDICAL CORPORATION
Practice Location Address:

745 SOUTH ALVARADO STREET
LOS ANGELES, CA
90057-4021

Practice Phone: 213-252-2225
Practice Fax: 213-252-2244

1457414856 — PETER AGAPAY LUCERO M.D.
Practice Location Address:

745 S ALVARADO ST
LOS ANGELES, CA
90057-4021

Practice Phone: 213-252-2225
Practice Fax: 213-252-2244

1083751358 — ROBERT CHEN MD
Practice Location Address:

2646 LAKE VIEW AVE
LOS ANGELES, CA
90039-4021

Practice Phone: 303-913-4146
Practice Fax:

1720113079 — MR. VICTOR FELIPE JIMENEZ P.A.C.
Practice Location Address:

745 S ALVARADO ST
LOS ANGELES, CA
90057-4021

Practice Phone: 213-252-2225
Practice Fax: 213-252-2244

1851599138 — EDMOND LEE CONGER LMFT
Practice Location Address:

2650 LAKE VIEW AVE
LOS ANGELES, CA
90039-4021

Practice Phone: 323-821-5955
Practice Fax:

1427327766 — KHATEREH A ASSADI M.D.
Practice Location Address:

741 S ALVARADO ST
LOS ANGELES, CA
90057-4021

Practice Phone: 213-413-6666
Practice Fax: 213-351-9504

Directions to “KIM & KIM PROFESSIONAL DENTAL CORP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.