DR. JONATHAN KIM (NPI# 1083084404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083084404 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN KIM |
| Credential | DDS |
| Practice Address |
27289 Willow Leaf Rd Moreno Valley CA 92555-4755 |
| Mailing Address |
18822 Chatfield Dr Riverside CA 92508-9312 |
| Practice Telephone | 6783616213 |
| Mailing Telephone | 6783616213 |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2018-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 60793892 | WA | Dental Providers |
| N | 122300000X | Dentist | 65136 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679120091 | Jonathan Kim | Dentist | 7910 W Tropical Pkwy Ste 140, Las Vegas, NV 89149-4555 | 2019-08-20 |
| 1497070734 | Jonathan Jaeyoung Kim | Chiropractor | 7 Broad Ave Ste 309, Palisades Park, NJ 07650-1886 | 2010-03-30 |
| 1457527418 | Jonathan H Kim | Dentist | 1725 Berryessa Rd, Suite B, San Jose, CA 95133-1173 | 2008-04-30 |
| 1073698650 | Jonathan Kim | Optometrist | 11903-i Lee Jackson Memorial Hwy. #g133, Fairfax, VA 22033 | 2006-10-25 |
| 1669418893 | Jonathan Yonghwan Kim | Chiropractor | 11766 Firestone Blvd, Norwalk, CA 90650-2898 | 2006-06-22 |
| 1013568294 | Jonathan Juyun Kim | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2019-09-27 |
| 1801390109 | Jonathan Kim | Student in an Organized Health Care Education/Training Program | 757 Westwood Plz, Los Angeles, CA 90095-8358 | 2018-03-21 |
| 1033643887 | Jonathan Kim | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2017-04-19 |
| 1093263444 | Jonathan Kim | Pharmacist | 3553 Whipple Rd, Union City, CA 94587-1507 | 2016-09-14 |
| 1982152534 | Jonathan Kim | Dentist | 1620 E 2nd St Ste A, Beaumont, CA 92223-3171 | 2016-09-13 |
| Street Address |
27289 WILLOW LEAF RD |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92555-4755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817935 | Jillian Mika Ogata | Social Worker | Riverside University Health System, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2020-10-05 |
| 1114549144 | Providence Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 11165 Bonnie View Ave, Moreno Valley, CA 92555 | 2020-05-13 |
| 1720645096 | Shahida Nawaz | Non-emergency Medical Transport (VAN) | 26528 Primrose Way, Moreno Valley, CA 92555 | 2019-05-22 |
| 1679139828 | Moses Lee | Student in an Organized Health Care Education/Training Program | Department of Orthopaedic Surgery Rm. B2042 Ruhs-mc, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2019-05-14 |
| 1215419668 | Johannes Wattimena | Counselor | 26624 Saffron Circle, Moreno Valley, CA 92555 | 2018-09-02 |
| 1437676939 | Aleksandra Vargas | Behavioral Analyst | 12549 Atherton Dr, Moreno Valley, CA 92555 | 2017-08-25 |
| 1063938603 | Anthony I Odimegwu | Nurse Practitioner | 26062 Bercaw Ct, Moreno Valley, CA 92555 | 2017-08-16 |
| 1073036703 | Karen Parker | Licensed Psychiatric Technician | 12944 Dolomite Lane, Moreno Valley, CA 92555 | 2017-07-25 |
| 1861923674 | Elena Vizcaino | Behavior Technician | 15670 Turnberry St, Moreno Valley, CA 92555 | 2017-03-23 |
| 1154744522 | Nancy Chivichon | Dietitian, Registered | 28648 Avenue Ave., Moreno Valley, CA 92555 | 2014-01-21 |
| Find all providers in zip 92555 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629554381 | Milton Melvin Vega | Dentist | 23569 Sunnymead Ranch Pkwy Ste A, Moreno Valley, CA 92557-2884 | 2018-07-16 |
| 1245777200 | Sunnymead Ranch Dental Center | Dentist | 23569 Sunnymead Ranch Pkwy, Suite A, Moreno Valley, CA 92557-2884 | 2017-01-27 |
| 1174971188 | Yara Stephania Soto Solis | Dentist | 24760 Sunnymead Blvd, Moreno Valley, CA 92553-3791 | 2016-05-31 |
| 1205299401 | Dr Vimal Patel,dds Inc | Dentist | 26150 Iris Ave Ste 6, Moreno Valley, CA 92555-3009 | 2016-04-04 |
| 1417339466 | Suchi Patel | Dentist | 23185 Hemlock Ave # 1, Moreno Valley, CA 92557-8043 | 2015-06-26 |
| 1881084374 | P. Pablo Gonzalez, Dds, A Prof Corp | Dentist | 15952 Perris Blvd Ste E, Moreno Valley, CA 92551-1320 | 2015-02-04 |
| 1689007593 | Kai K Wilcots | Dentist | 13373 Perris Blvd Ste D306, Moreno Valley, CA 92553-4208 | 2013-08-14 |
| 1689921025 | Sameh Said Sallam | Dentist | 26468 Sand Palm Ct, Moreno Valley, CA 92555-2368 | 2012-08-03 |
| 1346569670 | Suzanne Jensen | Dentist | 23767 Sunnymead Blvd, Moreno Valley, CA 92553-7750 | 2010-05-26 |
| 1396061222 | Don Phillip Schubothe | Dentist | 23767 Sunnymead Blvd Ste D, Moreno Valley, CA 92553-7750 | 2010-04-16 |
| Find all providers in MORENO VALLEY | ||||
| City | MORENO VALLEY |
| Zip Code | 92555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.