PREMIERE DENTAL CARE
NPI 1578736872
Dentist in Los Angeles, CA

Q: What is Min Seok Kim Dds Inc's NPI number?

The NPI number for Min Seok Kim Dds Inc is 1578736872. It was assigned to this organization in the NPPES registry on April 8, 2008. The provider is doing business as Premiere Dental Care.

Q: What is Min Seok Kim Dds Inc's specialty?

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

Active since April 08, 2008

3680 WILSHIRE BLVD STE 210, LOS ANGELES, CA 90010(213) 739-8855(213) 739-8899 Get Directions Write a Review

NPPES record last updated: April 12, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Premiere Dental Care NPPES

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

PREMIERE DENTAL CARE (NPI 1578736872) is a healthcare organization registered as a dentist in Los Angeles, California and active in the NPI registry since April 2008. The organization lists Min Seok Kim, President, as its authorized official.

NPPES Registry Identity

NPI1578736872

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameMIN SEOK KIM DDS INC

Location Address3680 WILSHIRE BLVD STE 210Los Angeles, CA 90010-2713

Mailing Address3680 Wilshire Blvd Ste 210Los Angeles, CA 90010-2713 · (213) 739-8855 · Fax (213) 739-8899

Phone(213) 739-8855

Fax(213) 739-8899

Organization SubpartNo

Authorized OfficialMin Seok KimPresident · (213) 249-2319

Enumeration DateApril 8, 2008

Last NPPES UpdateApril 12, 2019

✔ NPI 1578736872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 54166

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.

3680 WILSHIRE BLVD STE 210, Los Angeles, CA 90010

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Other Names 1

Doing Business AsPremiere Dental Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premiere Dental Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20130827000418Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Premiere Dental Care, which bills Medicare for the services this clinician delivers.

Clinician (1)

Min Kim, DDS

Oral Surgery

NPI 1427218619

13450 HAWTHORNE BLVD
Hawthorne, CA 90250

(310) 679-0106

✔ PECOS11 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Min Seok Kim Dds Inc's NPI number?

The NPI number for Min Seok Kim Dds Inc is 1578736872. It was assigned to this organization in the NPPES registry on April 8, 2008. The provider is doing business as Premiere Dental Care.

Where is Min Seok Kim Dds Inc located?

Min Seok Kim Dds Inc is located at 3680 Wilshire Blvd Ste 210, Los Angeles, CA 90010. The listed phone number is (213) 739-8855.

What is Min Seok Kim Dds Inc's specialty?

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

Is Min Seok Kim Dds Inc enrolled in Medicare?

Yes. Min Seok Kim Dds Inc is registered in the Medicare PECOS enrollment system.

When is Min Seok Kim Dds Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Min Seok Kim Dds Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to Min Seok Kim Dds Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Min Seok Kim Dds Inc was last updated on April 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.