MEDICARE: DR. DAESOON KIM D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	52412	CA

General Provider Information

NPI Number	:	1831212562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAESOON KIM D.D.S.

Provider Business Mailing Address
First Line	:	4105 ARENZANO WAY
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-5454
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1724 PROFESSIONAL DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-2105
Country	:	US
Telephone Number	:	916-482-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	01/24/2013

Similar Medicare Providers

1134218316 — DR. DANIEL LUM MAR D.D.S.
Practice Location Address:

1740 PROFESSIONAL DR
SACRAMENTO, CA
95825-2105

Practice Phone: 916-481-7103
Practice Fax:

1063571099 — PAULA LYNN WHITTINGHAM L.C.S.W.
Practice Location Address:

1722 PROFESSIONAL DR
SACRAMENTO, CA
95825-2105

Practice Phone: 916-801-2271
Practice Fax:

1043373848 — MS. CHERYL ELIZABETH MCVEY MFT
Practice Location Address:

1722 PROFESSIONAL DR
SACRAMENTO, CA
95825-2105

Practice Phone: 916-417-2192
Practice Fax: 916-973-9158

1245582121 — MRS. MARY M FOSSUM
Practice Location Address:

1722 PROFESSIONAL DR
SACRAMENTO, CA
95825-2105

Practice Phone: 916-716-0095
Practice Fax: 916-973-9158

1194242313 — CALIFORNIA KIDNEY DISEASE ASSOCIATES
Practice Location Address:

1736 PROFESSIONAL DR
SACRAMENTO, CA
95825-2105

Practice Phone: 916-500-4706
Practice Fax: 916-200-4999

1336809870 — PROFESSIONAL SMILE STUDIO
Practice Location Address:

1732 PROFESSIONAL DR
SACRAMENTO, CA
95825-2105

Practice Phone: 916-333-5903
Practice Fax:

Directions to “ DR. DAESOON KIM D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.