DR. YOO JUNG KIM DDS
NPI 1104359835
Dentist in Santa Cruz, CA

Q: What is Yoo Jung Kim's NPI number?

The NPI number for Yoo Jung Kim is 1104359835. It was assigned to this individual provider in the NPPES registry on April 10, 2017. The provider is also known as Yoo Kim.

Q: What is Yoo Jung Kim's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Yoo Jung Kim was last updated on September 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 10, 2017PECOS Enrolled

1830 COMMERCIAL WAY, SANTA CRUZ, CA 95065(831) 464-5409 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 14, 2021, Aug 7, 2018, Apr 10, 2017 (3 updates tracked since 2017).

On this page

About Dr. Yoo Jung Kim Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. YOO JUNG KIM DDS (NPI 1104359835) is an individual dentist in Santa Cruz, California, licensed in California (102411) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104359835

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. YOO JUNG KIMCredential: DDS

Location Address1830 COMMERCIAL WAYSanta Cruz, CA 95065

Mailing Address175 Venado WaySan Jose, CA 95123-3639 · (408) 309-5122

Phone(831) 464-5409

Sole ProprietorNo

Enumeration DateApril 10, 2017

Last NPPES UpdateSeptember 14, 20213 updates tracked since enumeration

NPPES CertifiedSeptember 14, 2021

✔ NPI 1104359835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 102411

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1830 COMMERCIAL WAY, Santa Cruz, CA 95065

Open in Google Maps ↗

Other Names 1

Other Name (5)Yoo Kim

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Yoo Jung Kim Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.03 typical visit price

range $62.97 – $186.69

Typical copayment $24.00 (range $15.74 – $46.67)

Most-billed visit code 99203

Established Patient

$77.84 typical visit price

range $21.02 – $153.16

Typical copayment $19.46 (range $5.25 – $38.29)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID WILLIAM WISTROM DDS

Dentist (General Practice)