Dr. Jennifer Park Kim, DDS
Dentist, General Practice in San Antonio, TX. Individual provider (NPI-1).
NPI number1013402692
StatusActive
Last updated in NPPESMay 26, 2022
Details
- NPI
- 1013402692
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jennifer Park Kim
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2018
- Certification date
- May 11, 2022
- Last updated
- May 26, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 34083 | TX | Yes |
Practice location
221 3rd St West, Bldg 1040San Antonio, TX 78148
Phone 210-652-1846
Mailing address
9127 Hogarten ParkConverse, TX 78109-2804
Phone 571-247-3137
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