DR. JEANIE KIM D.D.S.
NPI 1346427903
Dentist in San Rafael, CA

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 122300000X.

Active since January 25, 2008PECOS Enrolled

411 4TH ST, SUITE C, SAN RAFAEL, CA 94901(415) 473-5454(415) 473-5460 Get Directions Write a Review

NPPES record last updated: January 25, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Dr. Jeanie Kim D.d.s. NPPES

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

DR. JEANIE KIM D.D.S. (NPI 1346427903) is an individual dentist in San Rafael, California, licensed in California (56312) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346427903

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. JEANIE KIMCredential: D.D.S.

Location Address411 4TH ST, SUITE CSan Rafael, CA 94901-5716

Mailing Address411 4th St, Suite CSan Rafael, CA 94901-5716 · (415) 473-5454 · Fax (415) 473-5460

Phone(415) 473-5454

Fax(415) 473-5460

Sole ProprietorNo

Enumeration DateJanuary 25, 2008

✔ NPI 1346427903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 56312

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.

411 4TH ST, San Rafael, CA 94901

Open in Google Maps ↗

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. Jeanie 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 94901 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

$104.67 typical visit price

range $69.07 – $202.63

Typical copayment $26.16 (range $17.26 – $50.65)

Most-billed visit code 99203

Established Patient

$85.00 typical visit price

range $23.44 – $166.64

Typical copayment $21.25 (range $5.86 – $41.66)

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.