Jae Hee Shim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DDS102406 Issued in CA

Practice address

3450 Stine Rd
Bakersfield, CA 93309-6341

Phone

(661) 377-6453

NPI assigned

Apr 4, 2011

Last updated

Jan 28, 2019By the provider in NPPES

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

Enrolled in WA

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1417246000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 JEWETTA AVE APT L4",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933125496",
            "telephone_number": "509-823-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 STINE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933096341",
            "telephone_number": "661-377-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "JAE HEE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102406",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Shick
• Marshall Shieh, DPM
• Marietta Cacuyog Shields, RN
• Amy Shihady, FNP-C
• Brianna Shihrer
• Maryellen A Shimmel, RN, MFT
• Ben Shimogaki, O.D.
• Vanessa Anne Shin
• Shyi-Tang Shiue, M.D.
• David Dean Shively, DDS

• Dentist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.