DR. JESSE C KIM (NPI# 1780739367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780739367 |
| Entity Type | Individual |
| Full Name | DR. JESSE C KIM |
| Credential | D.D.S. |
| Practice Address |
1774 S. Broadway St. Santa Maria CA 93454 |
| Practice Telephone | 8059285400 |
| Practice Fax Number | 8059285574 |
| Mailing Telephone | 8059285400 |
| Mailing Fax Number | 8059285574 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D49346 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023398344 | Jesse Gawsung Kim | Dentist | 7190 Davenport Rd Apt 110, Goleta, CA 93117-2932 | 2011-08-17 |
| 1275689549 | Jesse H Kim | Emergency Medicine | Hospital: Wh3s9a, 549 Hc/baach, Unit 15245, Apo, AP 96271 | 2007-01-26 |
| 1912490194 | Jesse Kim | Physical Therapist | 6410 S Virginia St, Reno, NV 89511-1103 | 2018-06-12 |
| Street Address |
1774 S. BROADWAY ST. |
| City | SANTA MARIA |
| State | CA |
| Zip Code | 93454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995825 | Virgilia Elizabeth Kennedy | Counselor | 1505 Shepard Drive, Suite 204, Santa Maria, CA 93454 | 2019-01-05 |
| 1891290151 | Philbert Ramirez Pandac | Behavioral Analyst | 1016 East Maint Street, Santa Maria, CA 93454 | 2018-03-28 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| 1306357892 | Aklilu Joseph | Pharmacist | 1700 S. Bradley Rd, Santa Maria, CA 93454 | 2017-10-24 |
| 1225557267 | Eric Edward Lofstrand | Counselor | 1214 S Miller St Ste 11, Santa Maria, CA 93454 | 2017-09-11 |
| 1881112449 | Tess Wianecki | Physician Assistant | 116 S Palisade Dr Ste 110, Santa Maria, CA 93454 | 2017-09-05 |
| 1730603705 | Cac Alvin Center | Counselor | 316 E Mcelhany Ave, Santa Maria, CA 93454 | 2017-08-01 |
| 1174045009 | Peter A. Statti Md Inc. | Pediatrics | 1414 S. Miller St. #12, Santa Maria, CA 93454 | 2017-07-12 |
| 1982143970 | Child Abuse Listening Mediation | Community/Behavioral Health | 210 E. Enos Dr., Ste. A, Santa Maria, CA 93454 | 2017-02-23 |
| 1821531344 | Maria Isabel Lara | Counselor | 210 E Enos Dr, Santa Maria, CA 93454 | 2016-12-01 |
| Find all providers in zip 93454 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807336 | Chanvattanak Bun | Dentist | 1212 Jackie Ln, Santa Maria, CA 93454-5926 | 2020-09-28 |
| 1326651548 | Clayton Ore Johnson | Dentist | 1315 S Miller St Ste 201, Santa Maria, CA 93454-6910 | 2020-08-27 |
| 1508410002 | Stuart Stephen Adam | Dentist | 125 E Stowell Rd Ste 103, Santa Maria, CA 93454-6681 | 2019-08-01 |
| 1477119956 | Steven G. Johnson Dental Corporation | Dentist | 745 E Betteravia Rd, Santa Maria, CA 93454-7024 | 2019-05-10 |
| 1336602408 | Jose Miguel Rodriguez Ramos | Dentist | 238 E Betteravia Rd, Santa Maria, CA 93454-7889 | 2019-04-07 |
| 1821555608 | Cho Dental Corporation | Dentist | 1418 E Main St Ste 110, Santa Maria, CA 93454-4836 | 2019-02-27 |
| 1265955884 | James P. Xing | Dentist | 1414 S Miller St Ste S, Santa Maria, CA 93454-6962 | 2017-07-25 |
| 1063879997 | Azadeh Rastikerdar | Dentist | 1846 N Broadway # B, Santa Maria, CA 93454-1447 | 2016-01-22 |
| 1700280948 | Bing S Qiao Dds Inc. | Dentist | 1414 S Miller St., Suite S, Santa Maria, CA 93454-6915 | 2014-10-17 |
| 1922231729 | Zen Dental Group | Dentist | 2050 S Broadway Ste E, Santa Maria, CA 93454-8801 | 2009-08-26 |
| Find all providers in SANTA MARIA | ||||
| City | SANTA MARIA |
| Zip Code | 93454 |
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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.