Individual provider Active NPI

Jun Sik Kim, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lemoore, CA
National Provider Identifier
1114433703
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
51270 Issued in CA
Practice address
1270 N Lemoore Ave
Lemoore, CA 93245-2350
Phone
(559) 817-4080
Fax
(559) 817-4081
NPI assigned
Dec 19, 2017
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 51270 CA Primary

Addresses

Primary practice location

1270 N Lemoore Ave
Lemoore, CA 93245-2350

Mailing address

2366 E Pinehurst Ave
Fresno, CA 93730-5950
Phone (754) 610-2356

Other practice location 1

4041 W Caldwell Ave Ste A
Visalia, CA 93277-9200
Phone (559) 372-2388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
51270CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jun S Kim DDS Inc Orthodontics and Dentofacial Orthopedics CurrentSince Sep 12, 2021 Accepting new patients

Locations

1270 N Lemoore Ave
Lemoore, CA 93245
Phone (559) 817-4080

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1114433703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 E PINEHURST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937305950",
            "telephone_number": "754-610-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 N LEMOORE AVE",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932452350",
            "telephone_number": "559-817-4080",
            "fax_number": "559-817-4081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4041 W Caldwell Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932779200",
            "country_code": "US",
            "telephone_number": "559-372-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUN SIK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-19",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.