Jennifer Kim

Primary specialty

DentistTaxonomy code 122300000X

License

62877 Issued in CA

Practice address

5300 Beach Blvd
Suite #109
Buena Park, CA 90621-1250

Phone

(714) 522-3734

NPI assigned

Dec 16, 2013

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: jennifer.kimdds.p1@direct.jwch.nextgenshare.com

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.

• Young R. Kim, DDS, Inc

  • Dentist
  • Buena Park, CA
  • NPI 1912248832
  NPD (past)

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1730500893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 BEACH BLVD",
            "address_2": "SUITE #109",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906211250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 BEACH BLVD",
            "address_2": "SUITE #109",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906211250",
            "telephone_number": "714-522-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inja Kim, M.D.
• Insoo Kim, DDS
• Jack Son Kim, O.D.
• Jaewon Kim
• Jay Kim
• Jin Ri Kim
• Jong Kap Kim, L.AC, PH.D
• Joo Yeon Kim, MSW, ACSW
• Julie Jung Eun Kim, O.D.
• Julie Yongsook Kim, D.D.S

• Dentist in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.