James Jung Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

17957 Issued in TX

Practice address

12129 N FM 620
Suite 300
Austin, TX 78750

Phone

(512) 249-9147

Fax

(512) 249-9032

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063591964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12129 N FM 620",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78750",
            "telephone_number": "512-249-9147",
            "fax_number": "512-249-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 N FM 620",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78750",
            "telephone_number": "512-249-9147",
            "fax_number": "512-249-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAMES",
        "middle_name": "JUNG",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "017957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "800821",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dohyun Brandon Kim, PHARMD
• Gene Kim, M.D.
• Hanna Kim
• Hannah Kim
• Hyo Jeong Kim, DNP, CRNA
• Jemy F Kim, NP
• Jennifer Lee Kim, LPC ASSOCIATE
• Jenny Kim
• Jeremy Layn Kim, MD
• Ji Young Kim, MA., LPC

• Dentist in Austin, TX
• Providers in Austin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.