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DR. HYUNG TACK KIM D.D.S
NPI 1457554123
Dentist in Los Angeles, CA

Active since June 08, 2007PECOS EnrolledAccepts Medicare Assignment
2681 W OLYMPIC BLVD STE 220, LOS ANGELES, CA 90006(213) 251-8999(213) 251-8909 Get Directions Write a Review

NPPES record last updated: March 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 19, 2020, Mar 11, 2019 (2 updates tracked since 2019).

About Dr. Hyung Tack Kim D.d.s NPPES

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

DR. HYUNG TACK KIM D.D.S (NPI 1457554123) is an individual dentist in Los Angeles, California, licensed in California (55714) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1457554123
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. HYUNG TACK KIMCredential: D.D.S
Location Address2681 W OLYMPIC BLVD STE 220Los Angeles, CA 90006-2883
Mailing Address1751 Chantilly LnFullerton, CA 92833-1289 · (310) 893-9794
Phone(213) 251-8999
Fax(213) 251-8909
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateJune 8, 2007
Last NPPES UpdateMarch 19, 20202 updates tracked since enumeration
NPPES CertifiedMarch 19, 2020
✔ NPI 1457554123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 55714
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.
2681 W OLYMPIC BLVD STE 220, Los Angeles, CA 90006
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Secondary Practice Location 1

Location 13201 W Olympic Blvd # ALos Angeles, CA 90006-2316 · Phone (213) 251-8999 · Fax (213) 251-8909

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Hyung Tack Kim D.d.s is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971699513
PECOS Enrollment IDI20071012000443
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
65 services31 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
37 services37 patients
X-ray of lower jaws, upper jaws and teeth 70355
An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.
19 services19 patients
Application and removal of dental fixation device 21110
A dental fixation device helps stabilize and align your teeth or jaw. It's applied by a dental professional, often after surgery or injury. Over time, it aids in proper healing. Its removal, also done by a professional, occurs once the desired alignment is achieved.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90006 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.

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 Hyung Kim's NPI number?

The NPI number for Hyung Kim is 1457554123. It was assigned to this individual provider in the NPPES registry on June 8, 2007.

Where is Hyung Kim located?

Hyung Kim practices at 2681 W Olympic Blvd Ste 220, Los Angeles, CA 90006. The listed phone number is (213) 251-8999.

What is Hyung Kim's specialty?

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

Is Hyung Kim enrolled in Medicare?

Yes. Hyung Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Hyung Kim was last updated on March 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.