DR. JAE HO KIM (NPI# 1912216854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912216854 |
| Entity Type | Individual |
| Full Name | DR. JAE HO KIM |
| Credential | DDS |
| Practice Address |
5906 Bardstown Rd Louisville KY 40291-1935 |
| Mailing Address |
289 Ireland Ave Oral Surgery, Hospital Dental Clinic Fort Knox KY 40121-5111 |
| Practice Telephone | 8579194334 |
| Mailing Telephone | 8579194334 |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2015-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9554 | KY | Dental Providers |
| 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 |
| Street Address |
5906 BARDSTOWN RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40291-1935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821090226 | Joseph H Cieslak | Dentist | 5906 Bardstown Rd, Louisville, KY 40291-1935 | 2005-08-15 |
| 1215193974 | Joseph H. Cieslak, Dds, Pllc | Durable Medical Equipment & Medical Supplies | 5906 Bardstown Rd, Louisville, KY 40291-1935 | 2008-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881117166 | The Degondaba School, Inc. | Day Training, Developmentally Disabled Services | 5110 Stony Brook Drive, Louisville, KY 40291 | 2017-07-19 |
| 1497108278 | Andrea Herndon | Physician Assistant | 10710 Marceitta Ct, Louisville, KY 40291 | 2016-07-18 |
| 1033536602 | Jennifer Rose Fowler | Social Worker | 10300 Brookridge Villeage Blvd., Suite 104, Louisville, KY 40291 | 2014-03-21 |
| 1740602069 | Brittney Tatum | Licensed Practical Nurse | 9500 Glen Trace Ln, Louisville, KY 40291 | 2014-01-07 |
| 1326392895 | Lisa J Fetter | Nurse Practitioner | 6413 Bardstown Rd, Louisville, KY 40291 | 2012-11-05 |
| 1275829137 | Carolyn Estep Book | Counselor | 9612 Farmstead Lane, Louisville, KY 40291 | 2011-06-20 |
| 1023309028 | Julie Klein Hawkins | Pharmacist | 8014 Bardstown Rd., Louisville, KY 40291 | 2011-04-25 |
| 1295872653 | Loving Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9508 Fairmount Rd, Louisville, KY 40291 | 2007-02-01 |
| 1962548198 | Morgan Howard | Chiropractor | 5501 Bardstown Rd, Louisville, KY 40291 | 2007-01-29 |
| 1407992258 | Deanna H Smith | Social Worker | 9409 Cedar Look Drive, Louisville, KY 40291 | 2007-01-29 |
| Find all providers in zip 40291 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
| 1922361062 | Alan Reisman, Dds, PC | Dentist | 1075 S Boulder Rd Ste 135, Louisville, CO 80027-2559 | 2012-06-22 |
| 1245481175 | Joseph H. Cieslak Dds, Pllc | Dentist | 6501 Dixie Hwy, Louisville, KY 40258-3907 | 2008-10-09 |
| 1033372057 | Lawrence Sivori II | Dentist | 3101 Breckenridge Ln Ste 2d, Louisville, KY 40220-2742 | 2008-07-09 |
| 1790944106 | David Naselsker | Dentist | 3421 Hycliffe Ave, Louisville, KY 40207-3659 | 2008-06-02 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1730382722 | Lewis C. Jones | Dentist | 401 E Chestnut St Unit 550, Louisville, KY 40202-5705 | 2007-06-07 |
| 1104982016 | Mark D. Miller | Dentist | 1211 W Broadway Unit 106, Louisville, KY 40203-2082 | 2006-12-28 |
| 1285709865 | David T Dodd | Dentist | 4122 Shelbyville Rd Ste 120, Louisville, KY 40207-3206 | 2006-11-21 |
| 1306933387 | Alan Jon Reisman | Dentist | 1075 E South Boulder Rd, Suite 230, Louisville, CO 80027-2560 | 2006-10-09 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40291 |
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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.