Jee-Eun Kim, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN015834 Issued in GA

Practice address

3495 Peachtree Pkwy Ste 115
Suwanee, GA 30024-9101

Phone

(678) 408-2121

Fax

(678) 408-2121

NPI assigned

Jun 11, 2012

Sex

Female

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

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.

• Sprout Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Suwanee, GA
  • NPI 1336889435
  NPD Authorized official
• Jiten P. Gohel DMD PC

  • Dentist
  • West Chester, PA
  • NPI 1073843298
  NPD (past)

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1780946251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PEACHTREE PKWY STE 115",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249101",
            "telephone_number": "678-408-2121",
            "fax_number": "678-408-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 PEACHTREE PKWY STE 115",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249101",
            "telephone_number": "678-408-2121",
            "fax_number": "678-408-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEE-EUN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN015834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DO Young Kim, DC
• Eun Kyung Kim
• Farah Kim, DMD
• Haneul Kim, LCSW
• Hyun Kim
• Jenna May Kim, MD
• Jennifer Kim Jr., PMHNP
• Jinahn Kim, M.D.
• Jong Kyu Kim, DC, LAC
• Joseph Kim, APRN, FNP-C

• Pediatric Dentistry in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.