Individual provider Active NPI

Dan Yul Kim, D.D.S.

  • Dentist
  • Santa Barbara, CA
National Provider Identifier
1669474334
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51090 Issued in CA
Practice address
605 State St
Santa Barbara, CA 93101-3301
Phone
(805) 963-4296
Fax
(805) 962-8376
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 51090 CA Primary

Addresses

Primary practice location

605 State St
Santa Barbara, CA 93101-3301

Mailing address

605 State St
Santa Barbara, CA 93101-3301
Phone (805) 963-4296

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
I20150715000964 CA Order and Referring Only - DentistPractitioner - Dentist 0941513212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669474334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931013301",
            "telephone_number": "805-963-4296",
            "fax_number": "805-962-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931013301",
            "telephone_number": "805-963-4296",
            "fax_number": "805-962-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAN",
        "middle_name": "YUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.