Jinsang Kim, D.D.S., M.A.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DI19437 Issued in NJ

Practice address

669 Broad Ave Ste 102
Ridgefield, NJ 07657-1631

Phone

(201) 840-1123

Fax

(201) 840-5699

NPI assigned

Sep 17, 2008

Last updated

Sep 17, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 3S Orthodontics, P.a.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ridgefield, NJ
  • NPI 1306278858
  NPD (past) Authorized official

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1730338567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 BROAD AVE STE 102",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571631",
            "telephone_number": "201-840-1123",
            "fax_number": "201-840-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 BROAD AVE STE 102",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571631",
            "telephone_number": "201-840-1123",
            "fax_number": "201-840-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JINSANG",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI19437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Kyunghee Kim-Jin, L.AC
• Chan-Kyu Kim, DMD
• Dongkyun Daniel Kim, D.D.S.
• Esther Kim
• Jaeyeal Kim, LAC
• Kind ABA LLC
• Lauren Marie Krolick, LPC
• Regina Krug, P.T.
• Hyuk Y Kwon, L.AC
• Susan Leahy-Mulroe, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Ridgefield, NJ
• Providers in Ridgefield, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.