Dr Jake Kim, DDS is a
Dentist - General Practice based in Lake Dallas, Texas. Dr Jake Kim is licensed to practice in Texas (license number 39478) and his current practice location is
507 Jefferson Ln, Lake Dallas, Texas. He can be reached at his office (for appointments etc.) via phone at
(703) 477-4659.
NPI number for Dr Jake Kim is 1053981407 and his current mailing address is 507 Jefferson Ln, Lake Dallas, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053981407.
Healthcare Provider's Profile
| Full Name | Dr Jake Kim |
|---|
| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 507 Jefferson Ln, Lake Dallas, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1053981407
- Provider Enumeration Date: 06/28/2021
- Last Update Date: 11/24/2024
Medical Identifiers
Medical identifiers for Dr Jake Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053981407 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 39478 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jake Kim is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jake Kim, DDS
507 Jefferson Ln,
Lake Dallas, TX 75065-3489
Ph: (703) 477-4659 | Dr Jake Kim, DDS
507 Jefferson Ln,
Lake Dallas, TX 75065-3489
Ph: (703) 477-4659 |
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