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JASON KIM D.D.S
NPI 1265850754
Dentist in Portland, OR

Active since April 01, 2014PECOS Enrolled
4419 SE WOODSTOCK BLVD., PORTLAND, OR 97206(971) 261-0534 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Feb 28, 2018 (2 updates tracked since 2018).

About Jason Kim D.d.s NPPES

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

JASON KIM D.D.S (NPI 1265850754) is an individual dentist in Portland, Oregon, licensed in Oregon (D10016) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1265850754
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameJASON KIMCredential: D.D.S
Location Address4419 SE WOODSTOCK BLVD.Portland, OR 97206
Mailing Address2051 Kaen Rd Ste 367Oregon City, OR 97045-4035
Phone(971) 261-0534
Sole ProprietorYes
Enumeration DateApril 1, 2014
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1265850754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in OR · D10016✔ Licensed in MO · 2014006877
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.
4419 SE WOODSTOCK BLVD., Portland, OR 97206
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Secondary Practice Location 1

Location 14419 SE Woodstock Blvd.Portland, OR 97206 · Phone (971) 261-0534

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jason Kim D.d.s 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 97206 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason Kim's NPI number?

The NPI number for Jason Kim is 1265850754. It was assigned to this individual provider in the NPPES registry on April 1, 2014.

Where is Jason Kim located?

Jason Kim practices at 4419 SE Woodstock Blvd., Portland, OR 97206. The listed phone number is (971) 261-0534.

What is Jason Kim's specialty?

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

Is Jason Kim enrolled in Medicare?

Yes. Jason Kim is registered in the Medicare PECOS enrollment system.

What insurance does Jason Kim accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Dominion National and 5 other insurers list Jason Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jason Kim was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.