DR. JAYUN JOANNA KIM (NPI# 1194238956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194238956 |
| Entity Type | Individual |
| Full Name | DR. JAYUN JOANNA KIM |
| Credential | DMD |
| Practice Address |
1211 W Broadway Louisville KY 40203-2082 |
| Mailing Address |
5500 Worthington Place Dr Louisville KY 40241-2304 |
| Practice Telephone | 5028745178 |
| Mailing Telephone | 5027539941 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2020-03-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 10038 | KY | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
10038 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100499030 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 254 Market Place Dr, Louisville, KY 402295450 | 5029556134 |
| Street Address |
1211 W BROADWAY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40203-2082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568653848 | Kool Smiles, Psc | Dentist | 1211 W Broadway, Louisville, KY 40203-2007 | 2007-08-05 |
| 1730561614 | Anthony Schiro | Dentist | 1211 W Broadway, Louisville, KY 40203 | 2015-06-26 |
| 1154583409 | Razan Barazi | Dentist | 1211 W Broadway, Louisville, KY 40203-2082 | 2008-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211738 | Integrated Health Systems LLC | Psychiatry & Neurology | 645 S Roy Wilkins Ave Ste 300, Louisville, KY 40203 | 2018-07-18 |
| 1104317734 | Usimc of West Virginia Medical Corporation | Clinic/Center | 908 W Broadway Fl 8, Louisville, KY 40203 | 2018-05-18 |
| 1699296293 | Jennifer Christine Angermeier | Nurse Practitioner | 1130 W Chestnut St, Louisville, KY 40203 | 2017-07-05 |
| 1083162812 | Deloris Jean Johnson | Social Worker | 1022 South 6th Street, Louisville, KY 40203 | 2016-09-21 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1770906885 | Jason Scott Underhill | Counselor | 214 E Breckinridge St, Louisville, KY 40203 | 2014-01-24 |
| 1316372592 | Tonya Alicia Clay | Marriage & Family Therapist | 1000 South 5th Street, Family & Children's Place, Louisville, KY 40203 | 2013-09-06 |
| 1780929216 | Harambee Health Center, Inc | Clinic/Center | 800 South Preston St., Louisville, KY 40203 | 2012-12-10 |
| 1083977276 | Synergy Rehabilitation, Inc. | Physical Therapist | 832 S. 6th Street, Suite C, Louisville, KY 40203 | 2012-06-21 |
| 1043572803 | Sonya Helen Mitchell | Counselor | 2225 W. Broadway, Louisville, KY 40203 | 2012-06-07 |
| Find all providers in zip 40203 | ||||
| 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 |
|---|---|---|---|---|
| 1235781485 | Rylie Mike-mayer | Dentist | 302 Axis Dr Apt 401, Louisville, KY 40206-0139 | 2019-07-09 |
| 1922580653 | Advanced Dental Center, Inc. | Dentist | 1901 Rudy Ln Ste 4, Louisville, KY 40207-1384 | 2018-08-29 |
| 1043701451 | Diana H Tran | Dentist | 501 S Preston St Rm 148, Louisville, KY 40202-1701 | 2018-05-21 |
| 1992295653 | Tyler Benton Blount | Dentist | 8013 New La Grange Rd Ste 6, Louisville, KY 40222-4700 | 2018-05-17 |
| 1407346901 | Louisville Dental Associates LLC | Dentist | 16701 E Main St, Louisville, MS 39339-2751 | 2018-05-10 |
| 1194238816 | Dental Services of Kentucky, Psc | Dentist | 2011 Grinstead Dr Unit 102, Louisville, KY 40204-1296 | 2017-11-16 |
| 1366963373 | Caleb William Reece | Dentist | 2201 Biljana Dr Apt 1, Louisville, KY 40206-2175 | 2017-06-29 |
| 1205366846 | Triple Crown Dentistry | Dentist | 904 Lily Creek Road, Suite 101, Louisville, KY 40243 | 2017-06-15 |
| 1740733559 | Jonathan Mitchell, Dmd, Psc | Dentist | 1716 Gardiner Ln, Louisville, KY 40205-2738 | 2016-07-27 |
| 1215389168 | Charles Kendrick Bunch | Dentist | 1030 Mulberry St, Louisville, KY 40217-1253 | 2016-07-04 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40203 |
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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.