Jesse Kim,DDS.Inc

Primary specialty

DentistTaxonomy code 122300000X

License

D49346 Issued in CA

Legal business name

JESSE KIM,DDS.INC

Practice address

1774 S Broadway
Santa Maria, CA 93454-7604

Phone

(805) 928-5400

NPI assigned

Oct 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jesse Kim

Title

Ceo

Phone

(805) 928-5400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1437553682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 S BROADWAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 S BROADWAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547604",
            "telephone_number": "805-928-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSE KIM,DDS.INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-928-5400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D49346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Thomas Jensen, M.D.
• Chelsea Jensen
• Jody Michelle Jensen, PA-C
• Julie Ann Jensen
• Gregory L Jerkins, M.D.
• Janine Denise Jeter
• Jatae Jeter
• Nicolee A Jeter
• Melinda Jezierski, M.D.
• Chelsea Ji

• Dentist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.