Individual provider Active NPI

Go Eun Kim, DMD, MS

  • Dentist
  • Roseville, CA
National Provider Identifier
1518340009
Registry record updated Feb 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103251 Issued in CA
Practice address
9225 Sierra College Blvd
Roseville, CA 95661-5934
Phone
(916) 367-4680
NPI assigned
Jul 2, 2015
Last updated
Feb 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103251 CA Primary

Addresses

Primary practice location

9225 Sierra College Blvd
Roseville, CA 95661-5934

Mailing address

9225 Sierra College Blvd
Roseville, CA 95661-5934

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230609002317 CA Order and Referring Only - DentistPractitioner - Dentist 8123485927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771632000000",
    "number": "1518340009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 SIERRA COLLEGE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 SIERRA COLLEGE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615934",
            "telephone_number": "916-367-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GO EUN",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2026-02-21",
        "certification_date": "2026-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.