JENNIFER EUNJI KIM (NPI# 1790217115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790217115 |
| Entity Type | Individual |
| Full Name | JENNIFER EUNJI KIM |
| Credential | DDS |
| Practice Address |
1170 Lockhaven Way San Jose CA 95129-4031 |
| Mailing Address |
200 Belle Terre Rd Port Jefferson NY 11777-1928 |
| Practice Telephone | 4088920223 |
| Mailing Telephone | 6314746553 |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 103237 | CA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659837672 | Jennifer Kim | Physician Assistant | 18 Candy Ln, Syosset, NY 11791-4908 | 2019-02-14 |
| 1013402692 | Jennifer Park Kim | Dentist | 1671 Ih 35 E Ste 300, New Braunfels, TX 78130-6823 | 2018-06-26 |
| 1245756527 | Jennifer Kim | Behavior Technician | 7085 Tierra Roja St, El Paso, TX 79912-8492 | 2017-08-17 |
| 1205364650 | Jennifer Kim | Marriage & Family Therapist | 294 Harrington Ave Ste 6, Closter, NJ 07624-1912 | 2017-05-30 |
| 1588111645 | Jennifer Kim | Counselor | 323 N Serrano Ave Apt A, Los Angeles, CA 90004-2789 | 2016-09-07 |
| 1447614755 | Jennifer Hyun Kim | Pharmacist | 14433 Culver Dr, Irvine, CA 92604-0305 | 2016-04-12 |
| 1487035523 | Jennifer Kim | Student in an Organized Health Care Education/Training Program | 19925 22nd Ave, Whitestone, NY 11357-4121 | 2015-06-15 |
| 1255734778 | Jennifer Kim | Family Medicine | 4 E Clark Bass Blvd Ste 300, Mcalester, OK 74501-4269 | 2014-09-29 |
| 1174954879 | Jennifer Kim | Social Worker | 200 I St Se, Washington, DC 20003-3317 | 2013-12-05 |
| 1063853984 | Jennifer Kim | Pharmacist | 4048 Jenita Dr, Palm Harbor, FL 34685-1197 | 2013-07-08 |
| Street Address |
1170 LOCKHAVEN WAY |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95129-4031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528535176 | Sunlife Acupuncture Health Center Inc. | Acupuncturist | 6172 Bollinger Rd., San Jose, CA 95129 | 2018-10-31 |
| 1710472642 | Shen Zhang | Acupuncturist | 1072 S De Anza Blvd Ste A108, San Jose, CA 95129 | 2018-06-23 |
| 1023531217 | Rachana Vyas Dds Inc | Clinic/Center | 1002 S Deanza Blvd, #d, San Jose, CA 95129 | 2017-07-20 |
| 1477908119 | Emily O. Perrotta | Marriage & Family Therapist | 1745 Saratoga Ave #204, San Jose, CA 95129 | 2016-05-02 |
| 1306214325 | Amanda Montgomery | Psychologist | 4300 Stevens Creek Blvd Ste 260, San Jose, CA 95129 | 2015-09-08 |
| 1891065686 | Bobbie Edwards | Behavioral Analyst | 1479 Saratoga Ave, San Jose, CA 95129 | 2012-01-10 |
| 1659640753 | Gail Elizabeth Nabarrete | Social Worker | 780 Saratoga Ave, S310, San Jose, CA 95129 | 2011-12-19 |
| 1891063574 | Elizabeth Duell | Dentist | 4635 Piper Drive, San Jose, CA 95129 | 2011-12-08 |
| 1033486519 | Stephanie Truvonne Hawkins | Family Medicine | 9292 De Anza Blvd, Suite 101, San Jose, CA 95129 | 2011-11-28 |
| 1568607828 | Irina Vaynshteyn | Dentist | 1888 Saratoga Ave Ste 102, San Jose, CA 95129 | 2008-12-15 |
| Find all providers in zip 95129 | ||||
| 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 |
|---|---|---|---|---|
| 1558961359 | Tony Tataro | Dentist | 5700 Village Oaks Dr Apt 1222, San Jose, CA 95123-3771 | 2020-10-29 |
| 1306445689 | Vu Anh Tran | Dentist | 45 Via De Guadalupe, San Jose, CA 95116-2561 | 2020-10-19 |
| 1538775028 | Meera Sravan Kumar | Dentist | 451 Blossom Hill Rd Ste 20, San Jose, CA 95123-1658 | 2020-09-20 |
| 1750993937 | Ana Gloria Saint-hilaire | Dentist | 4676 Mia Cir, San Jose, CA 95136-2341 | 2020-08-19 |
| 1134746779 | Woodlief Dentistry & Associates, PC | Dentist | 750 N Capitol Ave Ste A2, San Jose, CA 95133-1902 | 2020-06-30 |
| 1871120485 | Brittany Chou | Dentist | 136 Birch Ln, San Jose, CA 95127-2310 | 2020-03-24 |
| 1164054235 | Amritha Raghunath Minisandram | Dentist | 7058 Heartland Way, San Jose, CA 95135-2234 | 2020-02-06 |
| 1124582580 | Mahsa Esfandiari | Dentist | 1706 Morocco Dr, San Jose, CA 95125-5823 | 2019-01-29 |
| 1689138547 | Quan Phuong Huynh | Dentist | 1855 Alum Rock Ave Ste B, San Jose, CA 95116-1398 | 2019-01-24 |
| 1790257848 | Sandra P. Lara Dds . Inc | Dentist | 1360 N Winchester Blvd Ste 3, San Jose, CA 95128-1150 | 2018-12-28 |
| Find all providers in SAN JOSE | ||||
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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.