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DR. KI M UM DDS
NPI 1114594702
Dentist in Cypress, CA

Active since June 10, 2021Opted out of Medicare · through Dec 19, 2026
5001 CERRITOS AVE STE A, CYPRESS, CA 90630(347) 688-6560 Get Directions Write a Review

NPPES record last updated: June 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Ki M Um Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KI M UM DDS (NPI 1114594702) is an individual dentist in Cypress, California, licensed in California (106224) and active in the NPI registry since June 2021. She has opted out of Medicare through December 19, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1114594702
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. KI M UMCredential: DDS
Location Address5001 CERRITOS AVE STE ACypress, CA 90630-4570
Mailing Address5001 Cerritos Ave Ste ACypress, CA 90630-4570 · (347) 688-6560
Phone(347) 688-6560
Sole ProprietorNo
Enumeration DateJune 10, 2021
NPPES CertifiedMay 26, 2021
✔ NPI 1114594702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 106224
Definition
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.
5001 CERRITOS AVE STE A, Cypress, CA 90630
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Ki M Um Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 19, 2022 through December 19, 2026.

Opt-Out Effective DateDecember 19, 2022
Opt-Out In Effect ThroughDecember 19, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90630 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

J UM DDS CYPRESS
Clinic/Center (Dental)
5001 CERRITOS AVE STE A
CYPRESS, CA 90630
Orange County (860) 491-6972
DR. JOHN SEONG KIM DDS
Dentist (General Practice)
5001 CERRITOS AVE STE A
CYPRESS, CA 90630
Orange County (714) 821-6171
DR. JONG UM DDS
Dentist
5001 CERRITOS AVE STE A
CYPRESS, CA 90630
Orange County (860) 325-0022

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ki Um's NPI number?

The NPI number for Ki Um is 1114594702. It was assigned to this individual provider in the NPPES registry on June 10, 2021.

Where is Ki Um located?

Ki Um practices at 5001 Cerritos Ave Ste A, Cypress, CA 90630. The listed phone number is (347) 688-6560.

What is Ki Um's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Ki Um enrolled in Medicare?

No. Ki Um has opted out of Medicare through December 19, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ki Um was last updated on June 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.