DR. JAE KIM


Address: 144 Boston Ave, Bridgeport, CT 06610-1604
Phone: 2034377561

DR. JAE KIM (NPI# 1548632607) 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) 1548632607
Entity Type Individual
Full Name DR. JAE KIM
Credential D.D.S
Practice Address 144 Boston Ave
Bridgeport
CT 06610-1604
Mailing Address 1955 Lake Ave
Altadena
CA 91001-3037
Practice Telephone 2034377561
Enumeration Date 2015-10-28
Last Update Date 2018-03-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223G0001X Dentist
Specialization: General Practice
65151 CA Dental Providers
Y 1223X0400X Dentist
Specialization: Orthodontics and Dentofacial Orthopedics
12130 CT Dental Providers
N 1223X0400X Dentist
Specialization: Orthodontics and Dentofacial Orthopedics
65151 CA Dental Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
531 Elm St, New Haven, CT 065114549 2039011323

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 144 BOSTON AVE
City BRIDGEPORT
State CT
Zip Code 06610-1604

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538392170 Wolcott Street Dental-2, PC Dentist 144 Boston Ave, Bridgeport, CT 06610-1604 2009-08-31
1629487293 Manmeet Kaur Arora Dentist 144 Boston Ave, Bridgeport, CT 06610-1604 2014-08-08
1730598285 Nirali Merchant Dentist 144 Boston Ave, Bridgeport, CT 06610-1604 2014-08-08
1386955193 Lalit Kapoor Dentist 144 Boston Ave, Bridgeport, CT 06610-1604 2010-06-25
1730316597 Saima A Khan Dentist 144 Boston Ave, Bridgeport, CT 06610-1604 2009-06-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215553698 Juan G Farfan Nurse Anesthetist, Certified Registered 267 Grant Sreet, Bridgeport, CT 06610 2020-06-22
1104446145 Deepak Rajkumar Vangipuram Student in an Organized Health Care Education/Training Program Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2020-04-20
1275152886 Soniya Abraham Student in an Organized Health Care Education/Training Program Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2020-04-14
1538621834 Yu Mi Kang Student in an Organized Health Care Education/Training Program 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 2019-04-04
1073075024 Ashwin Pramod Deshmukh Student in an Organized Health Care Education/Training Program Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2019-04-01
1790246866 Prachi Mangesh Pednekar Student in an Organized Health Care Education/Training Program Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 2019-03-29
1194247916 Jessica M. Maddern Social Worker 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 2017-07-13
1922532746 Megha Kureti Student in an Organized Health Care Education/Training Program 267 Grant St Fl 3, Bridgeport, CT 06610 2017-04-18
1831623099 Cynthia Joseph Walters Nurse Anesthetist, Certified Registered Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 2017-04-14
1285186148 Helen Leahy Nurse Practitioner 439 Mill Hill Ave., Bridgeport, CT 06610 2016-10-26
Find all providers in zip 06610

Taxonomy Information

Taxonomy Code 1223X0400X
Grouping Dental Providers
Classification Dentist
Specialization Orthodontics and Dentofacial Orthopedics

Taxonomy Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750696399 Connecticut Family Dental, Inc Dentist 3885 Main St, Suite 101, Bridgeport, CT 06606-2814 2010-08-06
1922271550 Shyam Desai Dentist 3741 Main St, Bridgeport, CT 06606-3609 2008-04-03
1356560346 Drs. Lacy & Weidman, Pllc Dentist 112 Hill St, Bridgeport, WV 26330-1756 2007-04-25
1184605974 Michael B Montanaro Dentist 5294 Park Ave, Bridgeport, CT 06604-1018 2005-11-08
1316571425 Myorthos Connecticut Orthodontics PC Dentist 3909 Main St, Bridgeport, CT 06606-2872 2020-02-27
1184258386 Myorthos Holdings, LLC Dentist 3909 Main St, Bridgeport, CT 06606-2872 2020-02-26
1700378916 Arthur Kim Dentist 2690 E Main St, Bridgeport, CT 06610-1422 2018-06-04
1881048080 Bridgeport Braces, LLC Dentist 3715 Main St, Suite 100, Bridgeport, CT 06606-3618 2016-04-14
1588048748 Ct Braces Bridgeport Orthodontics PC Dentist 3909 Main St, Suite A, Bridgeport, CT 06606-2872 2015-07-16
1467886614 Ismile Orthodonticsof LLC Dentist 2417 E Main St, Bridgeport, CT 06610-1802 2013-08-23
Find all providers in BRIDGEPORT

Competitor

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City BRIDGEPORT
Zip Code 06610

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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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