Jean H Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30020016 Issued in OH

Practice address

1044 Belmont Ave
Youngstown, OH 44504-1006

Phone

(330) 480-3689

Fax

(330) 480-2904

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Practice roles

Locations

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.

• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225
  Medicare reassignment NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Physical Therapist
  • Warren, OH
  • NPI 1528736972
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486252800000",
    "number": "1720165632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-3689",
            "fax_number": "330-480-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-3689",
            "fax_number": "330-480-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEAN",
        "middle_name": "H",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30020016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134661",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer William Kilgore, CDCA
• Dawn M. Kilroy, PTA
• Mimi Kim-Vass, LSW
• Chang Hun Kim, MD
• James Kim, MD
• Jung Min Kim, M.D.
• Mildred Kimberly
• Brenda Kimble
• Brock J Kimble
• Hyun la Kimble

• Dentist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2017; 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.