Jefferson Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS102616 Issued in CA

Practice address

5550 Carmel Mountain Rd Ste 101
San Diego, CA 92130-4861

Phone

(858) 251-1407

NPI assigned

Jul 13, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1275985384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 CARMEL MOUNTAIN RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921304861",
            "telephone_number": "858-251-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 CARMEL MOUNTAIN RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921304861",
            "telephone_number": "858-251-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEFFERSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009548",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Jinhee Kim, M.D.
• Jane K Kim, D.O.
• Jane Ye-Eun Kim, PHARMD
• Janeth F Kim, M.D.
• Jeehyun Kim
• Jennifer Kim, DO
• Jennifer Kim
• Jennifer Stowe Kim, NP
• Jenny Kim, MD
• Jenny Miyon Kim, M.D.

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.