Kelly Yeon Su Kim, DDS - Medicare Dentist in Laguna Niguel, CA

Kelly Yeon Su Kim, DDS is a medicare enrolled "Dentist - Pediatric Dentistry" provider in Laguna Niguel, California. Her current practice location is 30001 Crown Valley Pkwy, Suite G, Laguna Niguel, California. You can reach out to her office (for appointments etc.) via phone at (949) 495-4245.

Kelly Yeon Su Kim is licensed to practice in California (license number 58075) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053625715.

Contact Information

Kelly Yeon Su Kim, DDS
30001 Crown Valley Pkwy, Suite G,
Laguna Niguel, CA 92677-1723
(949) 495-4245
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameKelly Yeon Su Kim
GenderFemale
SpecialityDentist - Pediatric Dentistry
Location30001 Crown Valley Pkwy, Laguna Niguel, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053625715
  • Provider Enumeration Date: 08/04/2010
  • Last Update Date: 06/16/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 7214242825
  • Enrollment ID: I20150811005650

Medical Identifiers

Medical identifiers for Kelly Yeon Su Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053625715NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223P0221XDentist - Pediatric Dentistry 58075 (California)Primary
1223P0221XDentist - Pediatric Dentistry 055114 (New York)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Yeon Su Kim is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly Yeon Su Kim, DDS
30001 Crown Valley Pkwy, Suite G,
Laguna Niguel, CA 92677-1723

Ph: (949) 495-4245
Kelly Yeon Su Kim, DDS
30001 Crown Valley Pkwy, Suite G,
Laguna Niguel, CA 92677-1723

Ph: (949) 495-4245

Reviews and Comments


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Dr. Damian Newhart,
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Medicare: Medicare Enrolled
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Phone: 949-215-5500    
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Practice Location: 30101 Town Center Dr Ste 205, Laguna Niguel, CA 92677
Phone: 949-295-0940    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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