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Deactivated NPI 1760674907 Deactivated / Inactive NPI Female Practitioner

Grace Eun Hae Kim

Dentist • Redlands, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Grace Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 12, 2007
NPI Deactivation Date November 03, 2021
Total Practice Duration ~14 Years of Practice (2007 – 2021)

Professional Overview & Biography Verified Profile Summary

Grace Kim was a registered Dentist practicing in Redlands, CA. Throughout an active medical career spanning 14 years, Grace Kim provided care at the practice location at 503 BROOKSIDE AVE until profile deactivation on 2021-11-03.

Practice Location & Contact Primary Location

Practice Address

503 Brookside Ave

Redlands, CA 923734611

Telephone 9097937884
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Redlands, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 4.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
89 Specialists

Practicing in Redlands, 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 55864

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 1821480815

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated November 03, 2021

Record deactivated on November 03, 2021

NPI Profile Active August 20, 2014

NPI status registered as active in NPPES database

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Updated Practice Location August 20, 2014

Registered at 503 BROOKSIDE AVE, REDLANDS, CA 923734611 (Tel: 9097937884)

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Updated Business Mailing Address August 20, 2014

Registered at 503 BROOKSIDE AVE, REDLANDS, CA 923734611 (Tel: 9097937884)

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Provider Name / Credentials Updated August 20, 2014

Recorded as GRACE KIM

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 20, 2014

Dentist (License #55864 in CA)

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Initial NPI Registration & Enumeration August 12, 2007

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: 1760674907
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 12, 2007
Last Update: August 20, 2014
Deactivation Date: November 03, 2021

Mailing Address

503 Brookside Ave

Redlands, CA 923734611

Phone: 9097937884

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.