WATERFORD FAMILY DENTIST, DENTAL PRACTICE OF DR. CHARLES C. KIM, DDS
NPI 1437503356
Dentist - General Practice in Waterford, CA
NPI Status: Active since April 18, 2016
Contact Information
12142 YOSEMITE BLVD
WATERFORD, CA
ZIP 95386
Phone: (209) 874-2337
Fax: (209) 874-9822
- Organization
- Dentist
- General Practice
- CLIA Number: 05D2079717
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 06-22-2026
About WATERFORD FAMILY DENTIST, DENTAL PRACTICE OF DR. CHARLES C. KIM, DDS
This page provides the complete NPI Profile along with additional information for Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds, a provider established in Waterford, California operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1437503356 assigned on April 2016. The practitioner's primary taxonomy code is 1223G0001X with license number 61112 (CA). The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds. The authorized official of this NPI record is Dr. Charles Chanwoong Kim Dds (Ceo, Owner)
- NPI
- 1437503356
- Provider Legal Name
- CHARLES C. KIM, D.D.S., INC.
- Other Organization Name
- WATERFORD FAMILY DENTIST, DENTAL PRACTICE OF DR. CHARLES C. KIM, DDS
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 12142 YOSEMITE BLVD WATERFORD, CA 95386
- Location Phone
- (209) 874-2337
- Location Fax
- (209) 874-9822
- Mailing Address
- 12142 YOSEMITE BLVD WATERFORD, CA 95386
- Mailing Phone
- (209) 874-2337
- Mailing Fax
- (209) 874-9822
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-18-2016
- Last Update Date
- 04-18-2016
- Code Navigator
A dentist like Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- License No.
- 61112
- License State
- CA
- Taxonomy Description
- A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2079717
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- June 23, 2024
- Certificate Expiration Date
- June 22, 2026
- Laboratory Director
- CHAITANYA N. MAHIDA
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Waterford Family Dentist, Dental Practice Of Dr. Charles C. Kim, Dds in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1437503356, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437503356, enumerated as an "organization" on April 18, 2016.
The provider is located at 12142 YOSEMITE BLVD WATERFORD, CA 95386 and the phone number is (209) 874-2337.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
