Don Han Kim, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

54647 Issued in CA

Practice address

1441 Secret Ravine Pkwy Ste 160
Roseville, CA 95661-6044

Phone

(916) 787-1515

Fax

(916) 787-1516

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Heritage Oral Surgery and Implant Centers

  • Oral and Maxillofacial Surgery (Dentist)
  • Valencia, CA
  • NPI 1205479391
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1093937179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 SECRET RAVINE PKWY STE 160",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956616044",
            "telephone_number": "916-797-1515",
            "fax_number": "916-787-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 SECRET RAVINE PKWY STE 160",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956616044",
            "telephone_number": "916-787-1515",
            "fax_number": "916-787-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DON",
        "middle_name": "HAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "54647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Kim-Fisher
• Bonnie Kim
• Da Hee Kim, AMFT
• Daniel Kim
• Diana Hyun Kim, DDS
• Eric Kim, PHARMD
• Esther Hyeun Kim, PA-C
• Go Eun Kim, DMD, MS
• Ina Kim, MD
• Jennifer Kim

• Oral and Maxillofacial Surgery (Dentist) in Roseville, CA
• Providers in Roseville, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.