JD Kim MD, DDS, Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

50622 Issued in CA

Legal business name

JD KIM MD, DDS, INC

Practice address

4000 Tyler St Ste a
Riverside, CA 92503-3458

Phone

(951) 687-4460

Fax

(951) 687-7448

NPI assigned

Aug 11, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jeong Doo Kim, MD, DDSNPI 1578778825

Title

President

Phone

(310) 713-5159

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeong Doo Kim, M.D, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Riverside, CA
  • NPI 1578778825
  NPD (past) Authorized official

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1598044356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20760 PASEO DE LA RAMBLA",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "92887",
            "telephone_number": "310-713-5159",
            "fax_number": "951-687-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033458",
            "telephone_number": "951-687-4460",
            "fax_number": "951-687-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD KIM MD, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JEONG",
        "authorized_official_middle_name": "DOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-713-5159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward D. Javor, MD
• Jay Kyung Lee M.D. Apc
• Arindra Jayasekara, M.D..
• Folashade Jayeoba-Sampay, PMHNP-BC
• Halle Jaymes
• JD Medical Transportation LLC
• Je Chiropractic and Wellness
• Jean Cheng, M.D. Inc.
• Jean Cheng, M.D. Inc.
• Desirae Jean

• Oral and Maxillofacial Surgery (Dentist) in Riverside, CA
• Providers in Riverside, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.