Active NPI
Peace P Kim, D.D.S
- General Practice Dentistry
- Huntington Beach, CA
National Provider Identifier
1992103642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 63279
- Practice address
- 18672 Florida St
Suite 301
Huntington Beach, CA 92648 - Phone
- (714) 596-2177
- NPI assigned
- Dec 11, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS040224 | PA | |
| General Practice Dentistry | 1223G0001X | 63279 | CA | Primary |
Addresses
Primary practice location
18672 Florida St
Suite 301
Huntington Beach, CA 92648
Mailing address
18672 Florida St
Suite 301
Huntington Beach, CA 92648
Phone (714) 596-2177
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS040224 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peace Kim Dental, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Huntington Beach, CA
- NPI 1982074241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1992103642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18672 FLORIDA ST",
"address_2": "SUITE 301",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "92648",
"telephone_number": "714-596-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18672 FLORIDA ST",
"address_2": "SUITE 301",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "92648",
"telephone_number": "714-596-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PEACE",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-11",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS040224",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "63279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.