Peter M Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56021 Issued in CA

Practice address

2415 G St
Bakersfield, CA 93301-2809

Phone

(661) 631-1113

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Peter M Kim DMD, Inc.

  • Dental Clinic/Center
  • Bakersfield, CA
  • NPI 1447814454
  NPD Authorized official

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1972725844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 G ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012809",
            "telephone_number": "661-631-1113",
            "fax_number": "661-631-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 G ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012809",
            "telephone_number": "661-631-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD2835",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D6719",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73203050",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "985525",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "AZ0158860",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyung Kim, MD
• Michelle Kim, O.D.
• Minjung Kim, CRNA
• Paul Myung Kim, DPM
• Peter D Kim, DDS
• Sarah Kim
• Serena Yeseul Kim, PHARM D
• Solomon Kim, DPM
• Woo Kon Kim, ACUPUNCTURIST
• Yeon Ho Kim, DDS

• General Practice Dentistry in Bakersfield, CA
• Providers in Bakersfield, 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 Oct 11, 2020; 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.