Jisoo Kim, in San Jose, CA - Dentist

Jisoo Kim, is a Dentist based in San Jose, California. Jisoo Kim is licensed to practice in California (license number 109428) and her current practice location is 1628 Hostetter Rd Ste J, San Jose, California. She can be reached at her office (for appointments etc.) via phone at (408) 929-9999.

NPI number for Jisoo Kim is 1013796309 and her current mailing address is 1887 Greenfield Ave Apt 310, Los Angeles, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1013796309.

Contact Information

	Jisoo Kim,
	1628 Hostetter Rd Ste J, San Jose, CA 95131-3309
	(408) 929-9999
	Not Available

Healthcare Provider's Profile

Full Name	Jisoo Kim
Gender	Female
Speciality	Dentist
Location	1628 Hostetter Rd Ste J, San Jose, California
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1013796309
Provider Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023

Medical Identifiers

Medical identifiers for Jisoo Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013796309	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	109428 (California)	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. Jisoo 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
Jisoo Kim, 1887 Greenfield Ave Apt 310, Los Angeles, CA 90025-4416 Ph: (202) 684-0703	Jisoo Kim, 1628 Hostetter Rd Ste J, San Jose, CA 95131-3309 Ph: (408) 929-9999

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Dentist in San Jose, CA

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Magdalena Azzarelli, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1660 Hillsdale Ave, 130, San Jose, CA 95124 Phone: 408-267-2550 Fax: 408-267-1411
Dr. Aparna R. Naik, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 850 Saratoga Ave Apt E307, San Jose, CA 95129 Phone: 408-833-7992
Dr. Arline G Guinto Macaraeg, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 125 N Jackson Ave, Suite 207, San Jose, CA 95116 Phone: 408-258-9943 Fax: 408-258-9951
Dr. Cory Timbers, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 155 N Jackson Ave, Suite 202, San Jose, CA 95116 Phone: 408-251-3766

Jisoo Kim, - Dentist in San Jose, CA