Active NPI
Jae Woo Kim, D.M.D.
- General Practice Dentistry
- West Chester, PA
National Provider Identifier
1477745388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS037309
- Practice address
- 403 N Five Points Rd
West Chester, PA 19380-4632 - Phone
- (610) 696-3371
- Fax
- (610) 696-5058
- NPI assigned
- Aug 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS037309 | PA | Primary |
Addresses
Primary practice location
403 N Five Points Rd
West Chester, PA 19380-4632
Mailing address
403 N Five Points Rd
West Chester, PA 19380-4632
Phone (610) 696-3371
Other names 1
- Dr. Jeff Jaewoo Kim
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS037309 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Chester Dental Arts, LLC | General Practice | Past | Accepting new patients |
| Eric Shelly, DMD & Margaret Lee DMD | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- West Chester, PA
- NPI 1215018130
-
- General Practice Dentistry
- West Chester, PA
- NPI 1548425606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1477745388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 N FIVE POINTS RD",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193804632",
"telephone_number": "610-696-3371",
"fax_number": "610-696-5058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 N FIVE POINTS RD",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193804632",
"telephone_number": "610-696-3371",
"fax_number": "610-696-5058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAE",
"middle_name": "WOO",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-14",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS037309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEFF",
"last_name": "KIM",
"middle_name": "JAEWOO",
"prefix": "DR.",
"credential": "D.M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.