Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1861186165 Individual Practitioner Male Practitioner

Samuel Junwon Kim

Dentist • Altadena, CA

Professional Overview & Biography Verified Profile Summary

Samuel Kim is a registered healthcare professional specializing in Dentist in Altadena, CA. Practice services are available at 2095 LINCOLN AVE # 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2095 Lincoln Ave # 201

Altadena, CA 910015478

Telephone 6266104413

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Altadena, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
8 Specialists

Practicing in Altadena, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-23
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 113196

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1023681038

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 23, 2026

Registered at 2095 LINCOLN AVE # 201, ALTADENA, CA 910015478 (Tel: 6266104413)

📍
Updated Business Mailing Address June 23, 2026

Registered at 2552 E CRANE CT, ONTARIO, CA 917618587

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2026

Dentist (License #113196 in CA)

NPI Profile Active June 08, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location June 08, 2023

Registered at 24072 OAKRIDGE ST, CORONA, CA 928833612 (Tel: 7149061619)

📍
Updated Business Mailing Address June 08, 2023

Registered at 24072 OAKRIDGE ST, CORONA, CA 928833612

👤
Provider Name / Credentials Updated June 08, 2023

Recorded as SAMUEL KIM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 08, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861186165
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 08, 2023
Last Update: June 23, 2026
Sole Proprietor: Yes

Mailing Address

2552 E Crane Ct

Ontario, CA 917618587

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.