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DR. KEUN WON KIM DDS
NPI 1376329391
Dentist - General Practice in Manhattan Beach, CA

Active since September 05, 2023PECOS Enrolled
1200 ROSECRANS AVE STE 210, MANHATTAN BEACH, CA 90266(310) 414-0620 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Keun Won Kim Dds NPPES

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

DR. KEUN WON KIM DDS (NPI 1376329391) is an individual general practice provider in Manhattan Beach, California, licensed in California (109188) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376329391
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KEUN WON KIMCredential: DDS
Location Address1200 ROSECRANS AVE STE 210Manhattan Beach, CA 90266-2470
Mailing Address848 Gramercy Dr Apt 103Los Angeles, CA 90005-3417 · (310) 570-0053
Phone(310) 414-0620
Sole ProprietorNo
Enumeration DateSeptember 5, 2023
NPPES CertifiedSeptember 5, 2023
✔ NPI 1376329391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 109188
Definition
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.
1200 ROSECRANS AVE STE 210, Manhattan Beach, CA 90266
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keun Won Kim Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90266 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.

DR. MITRA ELISHA SIMANIAN DDS
Dentist
1200 ROSECRANS AVE STE 210
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 414-0620
SEA BREEZE DENTAL GROUP
Clinic/Center (Dental)
1200 ROSECRANS AVE STE 210
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 414-0620
SARAH MARIAM HADAR DMD
Dentist
1200 ROSECRANS AVE STE 210
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 414-0620

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 Keun Won Kim's NPI number?

The NPI number for Keun Won Kim is 1376329391. It was assigned to this individual provider in the NPPES registry on September 5, 2023.

Where is Keun Won Kim located?

Keun Won Kim practices at 1200 Rosecrans Ave Ste 210, Manhattan Beach, CA 90266. The listed phone number is (310) 414-0620.

What is Keun Won Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Keun Won Kim enrolled in Medicare?

Yes. Keun Won Kim is registered in the Medicare PECOS enrollment system.

What insurance does Keun Won Kim accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Keun Won Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keun Won Kim was last updated on September 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.