Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124969167 Individual Practitioner Male Practitioner

Dr. Charles Kim , DDS

Dentist - General Practice • Fremont, CA

Professional Overview & Biography Verified Profile Summary

Dr. Charles Kim, DDS is a registered healthcare professional specializing in Dentist - General Practice in Fremont, CA. Practice services are available at 104 BLACK MOUNTAIN CIR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

104 Black Mountain Cir

Fremont, CA 945366507

Telephone 5103867245

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fremont, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
161 Specialists

Practicing in Fremont, CA (18734 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: 2026-04-03
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 112801

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active April 03, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location April 03, 2026

Registered at 104 BLACK MOUNTAIN CIR, FREMONT, CA 945366507 (Tel: 5103867245)

📍
Updated Business Mailing Address April 03, 2026

Registered at 104 BLACK MOUNTAIN CIR, FREMONT, CA 945366507 (Tel: 5103867245)

👤
Provider Name / Credentials Updated April 03, 2026

Recorded as CHARLES KIM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2026

Dentist (License #112801 in CA)

🟢
Initial NPI Registration & Enumeration April 03, 2026

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: 1124969167
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 03, 2026
Last Update: April 03, 2026
Sole Proprietor: No

Mailing Address

104 Black Mountain Cir

Fremont, CA 945366507

Phone: 5103867245

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.