Daeuk David Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

102817 Issued in CA

Practice address

144 Waterfall LN
Brea, CA 92821-4348

Phone

(510) 926-9414

NPI assigned

Jul 18, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Daeuk David Kim Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kim & Lee a Dental Corporation

  • General Practice Dentistry
  • Anaheim, CA
  • NPI 1588288591
  Medicare reassignment NPD
• Kim & Lee DDS Inc.

  • General Practice Dentistry
  • Buena Park, CA
  • NPI 1558038513
  Medicare reassignment NPD
• Daeuk D Kim DDS, California Inc.

  • Dental Clinic/Center
  • Long Beach, CA
  • NPI 1841039229
  NPD Authorized official
• Daeuk D Kim DDS, a Dental Corporation

  • General Practice Dentistry
  • Brea, CA
  • NPI 1144889734
  Authorized official Same address or phone
• Solana Dental Corporation

  • Dentist
  • Upland, CA
  • NPI 1548186505
  Authorized official Same address or phone
• Jonathan S. Won DDS Inc

  dba Pacific Dental Care/ Dental Group

  • General Practice Dentistry
  • Palmdale, CA
  • NPI 1346482759
  NPD (past)
• Won J DDS Dental, Inc.

  dba Pacific Dental Care/Dental Group of Dr. Won

  • Dentist
  • Palmdale, CA
  • NPI 1700372679
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1356827737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 WATERFALL LN",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214348",
            "telephone_number": "510-926-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 WATERFALL LN",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214348",
            "telephone_number": "510-926-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAEUK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAEUK",
            "last_name": "KIM",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jessica Kierulff
• Kim DDS Inc
• Angela Kim, FNP-C
• Casey C Kim, PHARM.D.
• Chae Eun Kim, L.AC.
• Eun Kim
• Eunice Hope Kim, LCSW
• Helen G Kim
• Janna Kim, PHARM D
• Jessica Jung-Eun Kim, MD

• Dentist in Brea, CA
• Providers in Brea, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.