Jessica Kiyun Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109126 Issued in CA

Practice address

1957 Fremont Blvd
Seaside, CA 93955-3132

Phone

(831) 296-1333

NPI assigned

Aug 8, 2023

Sex

Female

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)

Not enrolled

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1306529235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10384 COLBY AVE",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142401",
            "telephone_number": "408-440-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 FREMONT BLVD",
            "city": "SEASIDE",
            "state": "CA",
            "postal_code": "939553132",
            "telephone_number": "831-296-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "KIYUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalena C Kaczynska, MD
• Michael S Kang, M.D.
• Emily Kaufman, WHNP
• Caroline Isik Kennedy, M.D.
• Dana Travis Kent, M.D.
• Jisu Kim
• Rei Lin Klingman, RN
• Cozzette Krings, NP
• La Palma Acupuncture Inc
• Lauren Cardoni Otrl Inc

• General Practice Dentistry in Seaside, CA
• Providers in Seaside, 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 Aug 18, 2023; 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.