Kelly Yeon Su Kim, D.D.S
Pediatric Dentistry · Laguna Niguel, CA
Kelly Yeon Su Kim, D.D.S is a pediatric dentistry with a practice address in Laguna Niguel, California, and NPI 1053625715, issued on Aug 4, 2010. Check the license (California 58075, as entered in NPPES) with the California board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Kelly Yeon Su Kim
- Credential
- D.D.S
- Primary taxonomy
- Pediatric Dentistry 1223P0221X
- License numbers
- 58075 CA
055114 NY
Self-reported in NPPES; status is on the state search - Practice location
- 30001 Crown Valley Pkwy, Laguna Niguel, CA 92677
- Phone
- (949) 495-4245
- Enumerated
- Aug 4, 2010
- Record last updated
- Jun 16, 2011 (not updated in 15 years: call before relying on the address or phone)
- Entity
- Type 1 · individual
Also registered at 30001 Crown Valley Pkwy
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Milena Imhof, PSYDClinical Psychologist1336333665
Verify Kelly Yeon Su Kim in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich California board licenses this profession
Search for license 58075Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Industry payments in 2024: $130.98
2 payments; by number, the most common kind was gift; the largest payer was Ultradent Products Inc. The 2,607 providers of this specialty with any payment received $434.77 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Pediatric Dentistry providers in California
There are 1,339 pediatric dentistry records in California.
Other pediatric dentistry records in California
- David Abazari, DMDMountain View, CA1639738149
- Leyla Abazari, DDS PED DENTISTRYPalo Alto, CA1669505475
- Carla Abboud, DDSValencia, CA1659430593
- Chad Abby, D.D.S.Bakersfield, CA1548496946
- Assal AbdossalehiBurbank, CA1447614599
- Therese Abely, DMDEl Cajon, CA1467208686
- Mohamad Abul-Fielat, D.D.S.Fontana, CA1275700510
- Joanna Aceto, D.D.S.Los Angeles, CA1033522578
- Daniel Aclan, DMDRoseville, CA1316510209
- Meena Adami, DDSRedlands, CA1013510932
Common questions
What is Kelly Yeon Su Kim, D.D.S's NPI number?
Kelly Yeon Su Kim, D.D.S's National Provider Identifier (NPI) is 1053625715, issued on Aug 4, 2010. An NPI identifies a provider in billing; it is not a license.
Where is Kelly Yeon Su Kim, D.D.S located?
The NPPES record lists a practice address at 30001 Crown Valley Pkwy, Laguna Niguel, CA, 92677. Phone: (949) 495-4245. Providers update this record themselves, so call before visiting.
How can I verify Kelly Yeon Su Kim, D.D.S's license?
NPPES lists California license number 58075, as entered by the provider. Search the California board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.