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KELLY YEON SU KIM D.D.S NPI 1053625715


NPI Information

NPI: 1053625715
Provider Name: KELLY YEON SU KIM, D.D.S
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

PECOS Registration: Yes

Address:
30001 CROWN VALLEY PKWY
SUITE G
LAGUNA NIGUEL, CA
ZIP 92677
Phone: (949) 495-4245
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Kelly Yeon Su Kim, D.D.S is a pediatric dentistry dentist in Laguna Niguel, CA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Kelly Yeon Su Kim, D.D.S NPI is 1053625715. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

30001 CROWN VALLEY PKWY
SUITE G
LAGUNA NIGUEL, CA
ZIP 92677-723
Phone: (949) 495-4245

The NPI 1053625715 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 8/4/2010 and was last updated on 6/16/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry055114NEW YORKNo
21223P0221XDentistPediatric Dentistry58075CALIFORNIAYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.