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SAMUEL JUNWON KIM
NPI 1861186165
Dentist in Altadena, CA

Active since June 08, 2023
2095 LINCOLN AVE # 201, ALTADENA, CA 91001(626) 610-4413 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samuel Junwon Kim NPPES

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

SAMUEL JUNWON KIM (NPI 1861186165) is an individual dentist in Altadena, California, licensed in California (113196) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1861186165
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameSAMUEL JUNWON KIM
Location Address2095 LINCOLN AVE # 201Altadena, CA 91001-5478
Mailing Address2552 E Crane CtOntario, CA 91761-8587
Phone(626) 610-4413
Sole ProprietorYes
Enumeration DateJune 8, 2023
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
✔ NPI 1861186165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 113196
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.
2095 LINCOLN AVE # 201, Altadena, CA 91001
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Other Providers at the Same Location NPPES

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

EDWARD MOUSSA DMD
Dentist
2095 LINCOLN AVE # 201
ALTADENA, CA 91001
Los Angeles County (626) 639-8618

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 Samuel Kim's NPI number?

The NPI number for Samuel Kim is 1861186165. It was assigned to this individual provider in the NPPES registry on June 8, 2023.

Where is Samuel Kim located?

Samuel Kim practices at 2095 Lincoln Ave # 201, Altadena, CA 91001. The listed phone number is (626) 610-4413.

What is Samuel Kim's specialty?

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

When was this NPI record last updated?

The NPPES record for Samuel Kim was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.