JAE DO KIM


Address: 205 South St, Fort Bragg, CA 95437-5540
Phone: 7079614088

JAE DO KIM (NPI# 1437501566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437501566
Entity Type Individual
Full Name JAE DO KIM
Credential D.D.S.
Practice Address 205 South St
Fort Bragg
CA 95437-5540
Mailing Address 5120 Nw 17th St
Oklahoma City
OK 73127-2858
Practice Telephone 7079614088
Mailing Telephone 6787179568
Enumeration Date 2016-07-13
Last Update Date 2018-09-13
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
102969 CA Dental Providers
N 390200000X Student in an Organized Health Care Education/Training Program NY Student, Health Care

Other Provider Identifier

State Issuer Identifier Type Code
IA DEA FK7241918 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Brookdale Plz, Brooklyn, NY 112123139 7182406552 7182406682

Other Providers JAE KIM

NPI Name Taxonomy Address Enumeration
1558778100 Jae Kim Pharmacist 14474 37th Ave, 1st Floor, Flushing, NY 11354-5934 2014-07-15
1215274865 Jae S. Kim Dentist 1025 N Fillmore St, A, Arlington, VA 22201-6701 2013-01-15
1306112875 Jae Hee Kim Pharmacist 1202 N 10th Pl Apt 1214, Renton, WA 98057-5635 2012-03-28
1548531536 Jae Chil Kim Physical Medicine & Rehabilitation 107 Redcliff Dr, Jefferson Hills, PA 15025-3139 2012-01-23
1407143191 Jae Man Kim Acupuncturist 3409 W Burbank Blvd, Burbank, CA 91505-2233 2011-07-01
1609168327 Jae Y Kim Otolaryngology 2200 Wilson Blvd Ste 102-219, Arlington, VA 22201-3397 2011-05-12
1689849176 Jae Hyun Kim Prosthetist 1918 Coliseum Blvd, Greensboro, NC 27403-3211 2008-04-25
1477745388 Jae Woo Kim Dentist 403 N Five Points Rd, West Chester, PA 19380-4632 2007-08-14
1083832273 Jae Gwon Kim Dentist 777 N. Rainbow Blvd., Ste. 395, Las Vegas, NV 89107 2007-04-23
1043359482 Jae Seung Kim Acupuncturist 3400 W Olympic Bl, Ste207, Los Angeles, CA 90019-2122 2007-02-05

Office Location

Street Address 205 SOUTH ST
City FORT BRAGG
State CA
Zip Code 95437-5540

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508861782 Wade Joseph Gray Family Medicine 205 South St, Fort Bragg, CA 95437-5540 2005-06-15
1477046027 Roy Campbell Dental Hygienist 205 South St, Fort Bragg, CA 95437-5540 2018-06-08
1457861783 Andrea Masters Nurse Practitioner 205 South St, Fort Bragg, CA 95437-5540 2017-09-29
1558790774 Nadege Nerette Physician Assistant 205 South St, Fort Bragg, CA 95437-5540 2013-11-07
1932532272 Svetlana Romanovna Mulcahy Nurse Practitioner 205 South St, Fort Bragg, CA 95437-5540 2013-08-09
1013257831 Kimberly Jill Celeri Dental Hygienist 205 South St, Fort Bragg, CA 95437-5540 2013-02-15
1821340480 Genevieve Marilyn Gonzalez Counselor 205 South St, Fort Bragg, CA 95437 2012-10-08
1447500988 Ted Michael Aames Counselor 205 South St, Fort Bragg, CA 95437-5540 2012-09-12
1740587229 Wendy J Carvajal Dentist 205 South St, Fort Bragg, CA 95437-5540 2011-02-18
1073841540 Lynne Barbara Bornheim Social Worker 205 South St, Fort Bragg, CA 95437 2009-11-21
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902357437 Mendocino Coast Hospitality Center Community/Behavioral Health 137 E. Oak Street, Fort Bragg, CA 95437 2016-10-19
1144604570 Erin Paul Community Health Worker 474 South Franklin Street, Fort Bragg, CA 95437 2015-07-15
1508125790 Joel Macgregor Green Marriage & Family Therapist 331- G Redwood Ave., Fort Bragg, CA 95437 2012-05-09
1013244102 Jenna Glasscock Counselor 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 2009-11-10
1770819641 Patrick Lenaghan Emergency Medicine 707 River Dr, Fort Bragg, CA 95437 2009-10-27
1043455827 M. Lee Baker Dentist 890 River Dr, Fort Bragg, CA 95437 2008-12-09
1528250495 Christine Anne Samas Social Worker 656a Harrison St., Fort Bragg, CA 95437 2007-08-15
1083822811 Katharine L. White Marriage & Family Therapist 137 E Oak Street, Fort Bragg, CA 95437 2007-05-17
1053525873 Marty Christine Johnson Marriage & Family Therapist 331 E. Redwood Ave, Fort Bragg, CA 95437 2007-05-10
1528114741 Kate Teresa Donohue Psychologist 19201 Noyo Acres Dr, Fort Bragg, CA 95437 2007-01-29
Find all providers in zip 95437

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750997110 William James Graham Iv Dentist Bldg B-6837 Normandy Dr, Fort Bragg, NC 28310-0001 2020-09-21
1679194906 Jeff Bertheola Dentist 825 Sequoia Cir, Fort Bragg, CA 95437-5422 2020-04-27
1114572229 Amanda C Blankenship Dentist Smoke Bomb Hill Dental Clinic 3817 Gruber Rd, Fort Bragg, NC 28310-0001 2019-08-06
1831754795 Ryan David Smith Dentist Bldg 4681 Logistics Ave, Fort Bragg, NC 28310-0001 2019-05-07
1588159263 Jenniffer Rendon-velasquez Dentist 3817 Gruber Rd, Fort Bragg, NC 28310-8925 2018-06-26
1912423377 Lejla Streets Dentist 2827 Reilly Rd, Fort Bragg, NC 28310-0001 2017-08-17
1033635420 Andrew Seun Dentist Bldg 6837 Normandy Drive, Fort Bragg, NC 28310-0001 2017-08-17
1184144479 Thomas William Hanna IIi Dentist Bldg C-6238 Ardennes St., Fort Bragg, NC 28307 2017-06-27
1598134769 Sidney Choi Dentist 499 E Chestnut St, Fort Bragg, CA 95437-4913 2015-09-17
1083048706 Gamal Ahmad Baker Dentist Logisitcs Ave Bldg M-4861, Us Army Dental Activity, Fort Bragg, NC 28310-7302 2013-08-29
Find all providers in FORT BRAGG

Competitor

Search similar providers

City FORT BRAGG
Zip Code 95437

Improve Information

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Dataset Information

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.

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