Anna Stephanie Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS111431 Issued in CA

Practice address

3640 Crocker Dr Ste 130
Sacramento, CA 95818-3970

Phone

(916) 550-9429

NPI assigned

Jun 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Reymond Bautista Dental Corporation

  • General Practice Dentistry
  • Sacramento, CA
  • NPI 1679039960
  NPD (past)

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1770324972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21525 ADDINGTON CT",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950144847",
            "telephone_number": "408-691-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 CROCKER DR STE 130",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958183970",
            "telephone_number": "916-550-9429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Knollcroft Rd",
            "address_purpose": "LOCATION",
            "city": "Lyons",
            "state": "NJ",
            "postal_code": "079395001",
            "country_code": "US",
            "telephone_number": "908-647-0180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANNA",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS111431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Kim-Dunlavey, MD
• Penelope Kim-Lim
• Ah Young Kim
• Alicia Kim
• Andres Kim
• Becky Mihae Kim
• Benjamin Kim
• Brian Kap-Soo Kim, M.D.
• Brittany Kim, DDS
• Calvin Inkwon Kim

• General Practice Dentistry in Sacramento, CA
• Providers in Sacramento, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.