Individual provider Active NPI

Johnathan Hyun Kim, DDS

  • Dentist
  • Redlands, CA
National Provider Identifier
1790356038
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
106446 Issued in CA
Practice address
1895 Orange Tree LN Ste 101
Redlands, CA 92374-0112
Phone
(909) 793-5270
NPI assigned
Jul 7, 2021
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 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 106446 CA Primary

Addresses

Primary practice location

1895 Orange Tree LN Ste 101
Redlands, CA 92374-0112

Mailing address

61 Donovan
Irvine, CA 92620-3882
Phone (909) 279-8323

Other practice location 1

24953 Paseo De Valencia Ste 2C
Laguna Hills, CA 92653-4337
Phone (949) 441-5617

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johnathan Kim D.D.S. Dental Practice Current Accepting new patients
Johnathan Hyun Kim DDS, Inc. Current Accepting new patients

Locations

24953 Paseo de Valencia
Ste 2C
Laguna Hills, CA 92653
Phone (949) 441-5617

1895 Orange Tree Ln
Ste 101
Redlands, CA 92374
Phone (909) 793-5270

Organizations & group practices 2

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1790356038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DONOVAN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203882",
            "telephone_number": "909-279-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 ORANGE TREE LN STE 101",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923740112",
            "telephone_number": "909-793-5270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24953 Paseo De Valencia Ste 2C",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926534337",
            "country_code": "US",
            "telephone_number": "949-441-5617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHNATHAN",
        "middle_name": "HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.