Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114083193 Individual Practitioner Male Practitioner

Dr. Ted Tae Yul Im , DDS

Dentist • Moreno Valley, CA

Professional Overview & Biography Verified Profile Summary

Dr. Ted Im, DDS is a registered healthcare professional specializing in Dentist in Moreno Valley, CA. Practice services are available at 23205 SUNNYMEAD BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

23205 Sunnymead Blvd

Moreno Valley, CA 925535246

Telephone 9512426242
Fax 9512424782
Associated Practice Facility / Clinic
🏢 Ted T. Im, Dds, Inc. Facility NPI 1770821423

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Moreno Valley, CA

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

Practicing in Moreno Valley, 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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 40950

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
D40950 (CA)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active September 19, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 19, 2016

Registered at 23205 SUNNYMEAD BLVD, MORENO VALLEY, CA 925535246 (Tel: 9512426242)

📍
Updated Business Mailing Address September 19, 2016

Registered at 23205 SUNNYMEAD BLVD, MORENO VALLEY, CA 925535246 (Tel: 9512426242)

👤
Provider Name / Credentials Updated September 19, 2016

Recorded as TED IM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 19, 2016

Dentist (License #40950 in CA)

🟢
Initial NPI Registration & Enumeration December 28, 2006

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: 1114083193
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 28, 2006
Last Update: September 19, 2016
Sole Proprietor: No

Mailing Address

23205 Sunnymead Blvd

Moreno Valley, CA 925535246

Phone: 9512426242

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.