Dr Jeong Doo Kim, MD, DDS - Medicare Dentist in Riverside, CA

Dr Jeong Doo Kim, MD, DDS is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in Riverside, California. His current practice location is 4000 Tyler St Ste A, Riverside, California. You can reach out to his office (for appointments etc.) via phone at (951) 687-4460.

Dr Jeong Doo Kim is licensed to practice in California (license number 50622) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578778825.

Contact Information

Dr Jeong Doo Kim, MD, DDS
4000 Tyler St Ste A,
Riverside, CA 92503-3458
(951) 687-4460
(951) 687-7448



Healthcare Provider's Profile

Full NameDr Jeong Doo Kim
GenderMale
SpecialityDentist - Oral And Maxillofacial Surgery
Location4000 Tyler St Ste A, Riverside, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1578778825
  • Provider Enumeration Date: 05/11/2007
  • Last Update Date: 10/18/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 5597077248
  • Enrollment ID: I20150708003217

Medical Identifiers

Medical identifiers for Dr Jeong Doo Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578778825NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223S0112XDentist - Oral And Maxillofacial Surgery 50622 (California)Primary
1223S0112XDentist - Oral And Maxillofacial Surgery A102220 (California)Secondary

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 Jeong Doo Kim is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jeong Doo Kim, MD, DDS
20505 Via Tenorio,
Yorba Linda, CA 92887-3239

Ph: (310) 713-5159
Dr Jeong Doo Kim, MD, DDS
4000 Tyler St Ste A,
Riverside, CA 92503-3458

Ph: (951) 687-4460

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Dentist in Riverside, CA

Dr. Kyungsin Park, DDS
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Phone: 951-780-9800    Fax: 951-780-3267
Han Som Lee,
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Practice Location: 3457 Arlington Ave Ste 109, Riverside, CA 92506
Phone: 951-742-5208    
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Practice Location: 2955 Van Buren Blvd, Ste H4, Riverside, CA 92503
Phone: 951-689-8544    Fax: 951-689-2465
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Practice Location: 4959 Arlington Ave Ste H, Riverside, CA 92504
Phone: 951-299-7101    Fax: 951-299-7101
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Phone: 951-352-9747    Fax: 951-352-2316
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Phone: 951-799-4911    Fax: 951-778-0799
Manuel Humberto Guevara, DDS,MS
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Practice Location: 3679 Arlington Ave, Riverside, CA 92506
Phone: 951-683-1811    Fax: 951-782-0649

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