Jennifer Park Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34083 Issued in TX

Practice address

221 3Rd St West, BLDG 1040
San Antonio, TX 78148

Phone

(210) 652-1846

NPI assigned

Jun 26, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mohan VR NB PLLC

  • General Practice Dentistry
  • New Braunfels, TX
  • NPI 1306588058
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1013402692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9127 HOGARTEN PARK",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092804",
            "telephone_number": "571-247-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST WEST, BLDG 1040",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78148",
            "telephone_number": "210-652-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JENNIFER",
        "middle_name": "PARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giwoo Kim, MD
• Grace Kim
• Heather Ailein Kim, D.O.
• Jared Kim
• Jennifer Kim, MD
• Joshua Hyunsoo Kim
• Judy Mihyun Kim, MD
• Juwan Kim
• Kara Danbi Kim, NP-C
• Kelly Gayeon Kim, DO

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.