TAE YUNG KIM (NPI# 1154842797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154842797 |
| Entity Type | Individual |
| Full Name | TAE YUNG KIM |
| Credential | DMD |
| Practice Address |
Bldg H 2005 Knight Lane Navy Medicine Support Command Attn: Medical Staff Svcs Jacksonville FL 32212 |
| Mailing Address |
505 West Bobier Drive Apt 302 Vista CA 92083 |
| Practice Telephone | 7607250140 |
| Mailing Telephone | 2159626316 |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2017-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS041435 | PA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568938561 | Tae Kim | Social Worker | Bld S370, Camp Humphreys Behavioral Health Clinic, Apo, AP 96251-0016 | 2018-10-17 |
| 1962906487 | Tae Y Kim | Student in an Organized Health Care Education/Training Program | 4020 Olmsted Ave, Los Angeles, CA 90008-2628 | 2018-03-20 |
| 1831603067 | Tae Kyong Kim | Chiropractor | 3740 Colony Dr Ste 150, San Antonio, TX 78230-2290 | 2017-11-27 |
| 1710400296 | Tae Hee Kim | Acupuncturist | 520 S Virgil Ave Ste 503, Los Angeles, CA 90020-1452 | 2017-07-17 |
| 1427579531 | Tae Kim | Case Manager/Care Coordinator | 5837 192nd St Fl 2, Fresh Meadows, NY 11365-2237 | 2017-06-28 |
| 1164876561 | Tae Sik Kim | Acupuncturist | 3701 50th St W, Rosamond, CA 93560-6725 | 2016-04-21 |
| 1891949368 | Tae Jung Kim | Specialist | 6123 229th St Fl 2, Oakland Gardens, NY 11364-2422 | 2008-11-11 |
| 1568629889 | Tae Kyu Kim | Family Medicine | 275 W Hospitality Ln Ste 200, San Bernardino, CA 92408-3238 | 2008-05-22 |
| 1174734719 | Tae Kim | Acupuncturist | 2040 Pacific Coast Hwy Ste Q, Lomita, CA 90717-2660 | 2007-05-25 |
| 1568512085 | Tae Kun Kim | Chiropractor | 3620 W Pioneer Dr Ste 109, Irving, TX 75061-1515 | 2007-01-10 |
| Street Address |
BLDG H 2005 KNIGHT LANE NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980550 | Richard Conway | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2005-08-29 |
| 1669023032 | Alek Montgomery | Dentist | Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-09-26 |
| 1134788615 | Hannah Yuni Chung | Dentist | Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-06-10 |
| 1073008819 | Rachel Alexandra Kurcz | Dentist | Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2018-06-25 |
| 1346768231 | Stephan Sidney Barrington | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2017-08-31 |
| 1528519147 | Conrad Chou | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2016-10-19 |
| 1730636903 | Us Navy | Clinic/Center | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2016-09-06 |
| 1760834980 | United Stated Navy | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Support Command Attn: Medical Sta, Jacksonville, FL 32212-0140 | 2016-07-12 |
| 1003285453 | Anthony James Marin | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2015-09-16 |
| 1922475110 | Brent Stewart Ford | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2015-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| 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 |
|---|---|---|---|---|
| 1962018424 | Sydney Fowler | Dentist | 12276 San Jose Blvd Ste 314, Jacksonville, FL 32223-8632 | 2020-09-21 |
| 1871106260 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 4445 Town Center Pkwy, Jacksonville, FL 32246-8565 | 2020-08-26 |
| 1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1659923118 | San Jose Aspen Pllc | Dentist | 10502 San Jose Blvd Ste B, Jacksonville, FL 32257-6209 | 2019-07-15 |
| 1326603176 | Evens Family Dental | Dentist | 13107 Atlantic Blvd, Jacksonville, FL 32225-7127 | 2019-05-07 |
| 1487123006 | Susan Prater Kudlats, D.m.d, P.a. | Dentist | 12620 Beach Blvd Ste 18, Jacksonville, FL 32246-7130 | 2018-11-14 |
| 1043792534 | Atlantic Dentistry Pa | Dentist | 13474 Atlantic Blvd Ste 109, Jacksonville, FL 32225-0100 | 2018-08-31 |
| 1447738620 | Argyle Dental Pllc | Dentist | 6001 Argyle Forest Blvd Ste 4, Jacksonville, FL 32244-6127 | 2018-07-31 |
| 1427534445 | Sandeep Chunduru | Dentist | 571 Yopp Rd Ste 308, Jacksonville, NC 28540-3683 | 2018-07-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
Please comment or provide details below to improve the information on TAE YUNG KIM.
| 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.