Peter Ung Kwon Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49769 Issued in CA

Practice address

1770 E Lambert Rd Ste 110
Brea, CA 92821-8001

Phone

(714) 529-0100

Fax

(714) 599-9898

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1922022458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAMBERT RD STE 110",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928218001",
            "telephone_number": "714-529-0100",
            "fax_number": "714-599-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAMBERT RD STE 110",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928218001",
            "telephone_number": "714-529-0100",
            "fax_number": "714-599-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "UNG KWON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jisun Kim, OTR/L
• Jonathan Kim, PMHNP-BC
• Jone Kim, DDS
• Judy Eunjoo Kim
• Myoung Su Kim
• Somang Praise Kim, PSYD
• Suzy Kim, M.D.
• Yongseong Kim, PT, DPT
• Meagan Balmas Kimbrell
• Kindride

• General Practice Dentistry in Brea, CA
• Providers in Brea, 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 Dec 13, 2021; 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.