Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1538052196 Individual Practitioner Female Practitioner

Grace Kim

Dentist - General Practice • San Pedro, CA

Professional Overview & Biography Verified Profile Summary

Grace Kim is a registered healthcare professional specializing in Dentist - General Practice in San Pedro, CA. Practice services are available at 425 S PACIFIC AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

425 S Pacific Ave

San Pedro, CA 907312625

Telephone 3105470202
Associated Practice Facility / Clinic
🏢 Harbor Community Clinic Inc Facility NPI 1831739614

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in San Pedro, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
30 Specialists

Practicing in San Pedro, 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: 2025-05-12
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 111597

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.

Practice Associates & Co-Workers

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

24 Associated Practitioners
Dr. John Russo , MD

Preventive Medicine - Public Health & General Preventive Medicine

NPI 1013120286

Doctor of Medicine (M.D.)

Karla Guzman Alba , ASW132718

Social Worker - Clinical

NPI 1043156094
NPI 1083031769

Doctor of Osteopathic Medicine (D.O.)

Dr. Maile Osborne , DDS

Dentist - General Practice

NPI 1104406123

Doctor of Dental Surgery

Cristhiam Santos , PA-C

Physician Assistant

NPI 1124618186

Physician Assistant (Certified)

Reese Isaacson

Internal Medicine

NPI 1154765998

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 02, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location June 02, 2025

Registered at 425 S PACIFIC AVE, SAN PEDRO, CA 907312625 (Tel: 3105470202)

📍
Updated Business Mailing Address June 02, 2025

Registered at 205D EVANS ST APT 4, BUFFALO, NY 142215618

👤
Provider Name / Credentials Updated June 02, 2025

Recorded as GRACE KIM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2025

Dentist (License #111597 in CA)

🟢
Initial NPI Registration & Enumeration June 02, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Grace Kim. Be the first to share your experience!

Sign in to leave a review for Grace Kim

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1538052196
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2025
Last Update: June 02, 2025
Sole Proprietor: No

Mailing Address

205d Evans St Apt 4

Buffalo, NY 142215618

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.