Jason Eugene Kim, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

7919446-9922 Issued in UT

Practice address

112 S 100 W
Tooele, UT 84074-2091

Phone

(435) 843-0225

NPI assigned

Jun 24, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1770894701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S 100 W",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S 100 W",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742091",
            "telephone_number": "435-843-0225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14425 S Bitterbrush Ln",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840209501",
            "country_code": "US",
            "telephone_number": "801-576-7107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JASON",
        "middle_name": "EUGENE",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10461",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7919446-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Jones, CCM
• Kyle H Jones, CRNA
• K T Reese DDS a Professional Corporation
• Evan T Kenison, LCSW
• Malaz Khamis
• Julee Kimball, APRN, FNP-C
• Michelle Elizabeth Kinder, SSW
• Sierra King
• Christine Kirk, RN
• Eric Klein, ASUDC INTERN

• Dentist in Tooele, UT
• Providers in Tooele, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.