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Dr. Paul Sung Jun Kim , DMD

Dentist - General Practice β€’ Commerce, CA

Active NPI 1114505138 Individual Practitioner Male Practitioner
Practice location in NPPES

972 Goodrich Blvd
Commerce, CA 900224114

Call 8183067150 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

972 Goodrich Blvd

Commerce, CA 900224114

Telephone 8183067150
Other Listings in Public Data

NPPES lists 4 distinct additional practice-address records in Aurora, CO; Brighton, CO; Denver, CO and 1 more. 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.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2021

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)

Dr. 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 Dr. 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 Commerce and California

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

Addresses are self-reported to NPPES and may be out of date.

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

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-04-01
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES CA 110095

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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

PRACTITIONER - DENTIST

Medicare Enrollment ID

I20230119003394

Enrollment State Jurisdiction

CO

PECOS Control ID

6800262486

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

3292 Peoria St

Aurora, CO 800101517

Phone: 3033606276

17866 Cottonwood Dr

Parker, CO 801343924

Phone: 3033606276

301 W 6th Ave

Denver, CO 802045182

Phone: 3034366000

3494 Eagle Blvd

Brighton, CO 806017403

Phone: 8183067150

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Dr. Robert Hernandez , MD

Family Medicine - Sports Medicine

NPI 1861974669

Doctor of Medicine (M.D.)

NPI 1417675620

Doctor of Dental Medicine

NPI 1841442738

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

12 Historical Events
πŸ“
Updated Practice Location April 01, 2025

Registered at 972 GOODRICH BLVD, COMMERCE, CA 900224114 (Tel: 8183067150)

πŸ“
Updated Business Mailing Address April 01, 2025

Registered at 972 GOODRICH BLVD, COMMERCE, CA 900224114 (Tel: 8183067150)

πŸ‘€
Provider Name / Credentials Updated April 01, 2025

Recorded as PAUL KIM, DMD

πŸ“
Updated Practice Location January 06, 2023

Registered at 3292 PEORIA ST, AURORA, CO 800101517 (Tel: 3033606276)

πŸ“
Updated Business Mailing Address January 06, 2023

Registered at 2255 S ONEIDA ST, DENVER, CO 802242522 (Tel: 3037611977)

πŸ“
Updated Practice Location July 11, 2022

Registered at 3494 EAGLE BLVD, BRIGHTON, CO 806017403 (Tel: 8183067150)

βœ…
NPI Profile Active March 31, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 31, 2021

Registered at 301 W 6TH AVE, DENVER, CO 802045182 (Tel: 3034366000)

πŸ“
Business Mailing Address (Initial Record) March 31, 2021

Registered at 743 S LONGWOOD AVE, LOS ANGELES, CA 900053826 (Tel: 8183067150)

πŸ‘€
Provider Name / Credentials (Initial Record) March 31, 2021

Recorded as PAUL KIM

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 31, 2021

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration March 31, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114505138
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 31, 2021
Last Update: April 01, 2025
Sole Proprietor: Yes

Other Dentist - General Practices in Commerce

Mailing Address

972 Goodrich Blvd

Commerce, CA 900224114

Phone: 8183067150

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.