Individual provider Active NPI

Daniel Charles Kim, D.M.D.

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1558677872
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59578 Issued in CA
Practice address
2513 Mission St
San Francisco, CA 94110-2511
Phone
(415) 641-1001
NPI assigned
Aug 24, 2010
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59578 CA Primary

Addresses

Primary practice location

2513 Mission St
San Francisco, CA 94110-2511

Mailing address

2513 Mission St
San Francisco, CA 94110-2511
Phone (415) 738-7488

Other practice location 1

675 Mariners Island Blvd Ste 105
San Mateo, CA 94404-1040
Phone (650) 345-5711

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
59578CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
D Kim DMD CurrentSince Dec 10, 2023 Accepting new patients
Daniel C Kim, DMD, PC CurrentSince Dec 17, 2023 Accepting new patients

Locations

675 Mariners Island Blvd
Ste 105
San Mateo, CA 94404
Phone (650) 345-5711

Organizations & group practices 3

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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1558677872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102511",
            "telephone_number": "415-738-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102511",
            "telephone_number": "415-641-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Mariners Island Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944041040",
            "country_code": "US",
            "telephone_number": "650-345-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "CHARLES",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-24",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.