Jungnam E Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30016344 Issued in OH

Practice address

6835 Broadway Ave
Metrohealth Broadway Health Center
Cleveland, OH 44105-1313

Phone

(216) 957-1500

NPI assigned

Aug 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942219969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6835 BROADWAY AVE",
            "address_2": "METROHEALTH BROADWAY HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441051313",
            "telephone_number": "216-957-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6835 BROADWAY AVE",
            "address_2": "METROHEALTH BROADWAY HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441051313",
            "telephone_number": "216-957-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNGNAM",
        "middle_name": "E",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0489163",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hyun Kim, DO
• Jaekeun Kim, MD, PHD, FACS
• Jin Young Kim, MD
• John Il-Chung Kim, M.D.
• June L Kim, ACNP
• Lisa Kibum Asamoto Kim, MD
• Luke Dogyun Kim, MD
• Mary Kim
• Rebecca Kim, APRN
• Roy J Kim, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.