Active NPI
Jennifer Hyunjung Kim, D.D.S
- Pediatric Dentistry
- Hartsdale, NY
National Provider Identifier
1033426390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 055236
- Practice address
- 99 Fieldstone Dr
Hartsdale, NY 10530-1564 - Phone
- (562) 405-2001
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 055236 | NY | Primary |
Addresses
Primary practice location
99 Fieldstone Dr
Hartsdale, NY 10530-1564
Mailing address
50 Forest St Apt 1125
Stamford, CT 06901-1871
Phone (562) 405-2001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055236 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474243200000",
"number": "1033426390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 FOREST ST APT 1125",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069011871",
"telephone_number": "562-405-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 FIELDSTONE DR",
"city": "HARTSDALE",
"state": "NY",
"postal_code": "105301564",
"telephone_number": "562-405-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JENNIFER",
"middle_name": "HYUNJUNG",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2016-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "055236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartsdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.