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John Kim

Dentist - General Practice β€’ Berkeley, CA

Active NPI 1831556117 Individual Practitioner Male Practitioner
Practice location in NPPES

1080 Jones St Apt 411
Berkeley, CA 947101559

Call 6266443614 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1080 Jones St Apt 411

Berkeley, CA 947101559

Telephone 6266443614
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Lakewood, WA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

What Public CMS Data Show

Dentist - General Practice: NPPES taxonomy is a reported classification, not proof of board certification.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $30.59 in 2022

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2022.

Guide: How to read an Open Payments record

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

John Kim has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists John Kim as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Berkeley and California

72 active clinicians are listed under Dentist - General Practice with a practice address in Berkeley, CA (17,862 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Berkeley

0% of these 72 clinicians have the CMS telehealth indicator.

0% of these 72 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2022), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2022

Program year 2022 (payments made January 1 – December 31, 2022): fewer than 11 records totaling $30.59.

Manufacturer Payment Nature Product Type Amount ($)
Straumann USA LLC
Food and Beverage
Cash or cash equivalent
β€” General $30.59

Source: CMS Open Payments, program year 2022, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-06-10
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES CA 65365

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist

NUCC Taxonomy Code: 122300000X

License # reported to NPPES WA DE60678182

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DENTIST

Medicare Enrollment ID

I20160509001771

Enrollment State Jurisdiction

CA

PECOS Control ID

6709185077

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

10011 Bridgeport Way Sw, Ste 700

Lakewood, WA 984992332

Phone: 2532151101

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location July 06, 2022

Registered at 1080 JONES ST APT 411, BERKELEY, CA 947101559 (Tel: 6266443614)

πŸ“
Updated Business Mailing Address July 06, 2022

Registered at 1080 JONES ST APT 411, BERKELEY, CA 947101559 (Tel: 6266443614)

βœ…
NPI Profile Active December 01, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) December 01, 2016

Registered at 10011 BRIDGEPORT WAY SW, STE 700, LAKEWOOD, WA 984992332 (Tel: 2532151101)

πŸ“
Business Mailing Address (Initial Record) December 01, 2016

Registered at 10011 BRIDGEPORT WAY SW, STE 700, LAKEWOOD, WA 984992332 (Tel: 2532151101)

πŸ‘€
Provider Name / Credentials (Initial Record) December 01, 2016

Recorded as JOHN KIM

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 01, 2016

Dentist (license number reported to NPPES: WA DE60678182)

🟒
Initial NPI Registration & Enumeration January 18, 2016

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1831556117
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 18, 2016
Last Update: July 06, 2022
Sole Proprietor: No

Other Dentist - General Practices in Berkeley

All Dentist - General Practices in Berkeley

Mailing Address

1080 Jones St Apt 411

Berkeley, CA 947101559

Phone: 6266443614

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.