Sean Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61028 Issued in CA

Practice address

23772 Mercury Rd
Lake Forest, CA 92630-2810

Phone

(213) 713-7922

NPI assigned

Jul 28, 2010

Sex

Male

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

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 and National Provider Directory roles.

• Sean Sanghoon Kim DDS

  • Dental Clinic/Center
  • Lake Forest, CA
  • NPI 1043911571
  NPD Authorized official

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1790099174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 WINNETT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021908",
            "telephone_number": "213-713-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23772 MERCURY RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302810",
            "telephone_number": "213-713-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Tang, M.D., Inc.
• Kim Yen Nguyen DDS Inc
• Elizabeth Ga Yeun Kim, D.D.S.
• Ji Yun Kim
• Jung-Joo Kim, D.C.
• Emily Kincaid, PA
• Kinetix Performance Physical Therapy, Inc.
• Maiko Sylvia King
• Tony King, M.D.
• Oxana Kireeva, LMFT, APCC

• General Practice Dentistry in Lake Forest, CA
• Providers in Lake Forest, 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 May 5, 2025; 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.