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DR. KI WAN KIM D.D.S.
NPI 1689961120
Dentist - Endodontics in Oceanside, CA

Active since July 05, 2011PECOS Enrolled
3601 VISTA WAY, SUITE #202, OCEANSIDE, CA 92056(760) 439-1871 Get Directions Write a Review

NPPES record last updated: November 14, 2014. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Ki Wan Kim D.d.s. NPPES

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

DR. KI WAN KIM D.D.S. (NPI 1689961120) is an individual endodontics provider in Oceanside, California, licensed in California (63507) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689961120
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. KI WAN KIMCredential: D.D.S.
Location Address3601 VISTA WAY, SUITE #202Oceanside, CA 92056-4559
Mailing Address3601 Vista Way, Suite #202Oceanside, CA 92056-4559
Phone(760) 439-1871
Sole ProprietorYes
Enumeration DateJuly 5, 2011
Last NPPES UpdateNovember 14, 2014
✔ NPI 1689961120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in CA · 63507
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3601 VISTA WAY, Oceanside, CA 92056
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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. Ki Wan Kim D.d.s. 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 92056 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
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 6

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

MICHELLE GONZALES M.D.
Family Medicine
3601 VISTA WAY, SUITE 201
OCEANSIDE, CA 92056
San Diego County (760) 639-1204
DR. ANDRES ZIMMERMANN MD
Internal Medicine (Geriatric Medicine)
3601 VISTA WAY, SUITE 201
OCEANSIDE, CA 92056
San Diego County (760) 639-1714
RADY CHILDREN'S HOSPITAL SAN DIEGO
General Acute Care Hospital
3601 VISTA WAY, SUITE 201
OCEANSIDE, CA 92056
San Diego County (858) 966-1700
WILSON LIU M.D.
Family Medicine
3601 VISTA WAY, SUITE 201
OCEANSIDE, CA 92056
San Diego County (760) 529-9503
CHAD BURGESS
Dentist (Endodontics)
3601 VISTA WAY, SUITE 202
OCEANSIDE, CA 92056
San Diego County (760) 216-3600
MICHELLE GONZALES MD PC
Family Medicine
3601 VISTA WAY, SUITE 201
OCEANSIDE, CA 92056
San Diego County (760) 639-1204

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 Wan Kim's NPI number?

The NPI number for Ki Wan Kim is 1689961120. It was assigned to this individual provider in the NPPES registry on July 5, 2011.

Where is Ki Wan Kim located?

Ki Wan Kim practices at 3601 Vista Way Suite #202, Oceanside, CA 92056. The listed phone number is (760) 439-1871.

What is Ki Wan Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Ki Wan Kim enrolled in Medicare?

Yes. Ki Wan Kim is registered in the Medicare PECOS enrollment system.

What insurance does Ki Wan Kim accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and Renaissance Dental list Ki Wan 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 Ki Wan Kim was last updated on November 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.