Active NPI
Jone Kim, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Brea, CA
National Provider Identifier
1982643110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 41843
- Practice address
- 400 W Central Ave
Suite 109
Brea, CA 92821-3013 - Phone
- (714) 529-0043
- Fax
- (714) 529-1019
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 41843 | CA | Primary |
Addresses
Primary practice location
400 W Central Ave
Suite 109
Brea, CA 92821-3013
Mailing address
400 W Central Ave
Suite 109
Brea, CA 92821-3013
Phone (714) 529-0043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 19, 2016 through Jan 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41843 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1982643110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W CENTRAL AVE",
"address_2": "SUITE 109",
"city": "BREA",
"state": "CA",
"postal_code": "928213013",
"telephone_number": "714-529-0043",
"fax_number": "714-529-1019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W CENTRAL AVE",
"address_2": "SUITE 109",
"city": "BREA",
"state": "CA",
"postal_code": "928213013",
"telephone_number": "714-529-0043",
"fax_number": "714-529-1019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JONE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "41843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.