JIWON LIM DMD, MPH
NPI 1417573312
Dentist in Charlottesville, VA

Q: What is Jiwon Lim's NPI number?

The NPI number for Jiwon Lim is 1417573312. It was assigned to this individual provider in the NPPES registry on June 17, 2020.

Q: What is Jiwon Lim'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 Jiwon Lim was last updated on April 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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 June 17, 2020PECOS EnrolledAccepts Medicare Assignment

1222 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903(434) 924-1774(434) 982-6417 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 9, 2025, Dec 1, 2022, Jun 18, 2020 (3 updates tracked since 2020).

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About Jiwon Lim Dmd, Mph NPPES

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

JIWON LIM DMD, MPH (NPI 1417573312) is an individual dentist in Charlottesville, Virginia, licensed in Virginia (0411000075) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with University Of Virginia Medical Center, and is a graduate of East Carolina University School Of Dentistry (2021).

NPPES Registry Identity

NPI1417573312

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameJIWON LIMCredential: DMD, MPH

Location Address1222 JEFFERSON PARK AVECharlottesville, VA 22903-3410

Mailing AddressPo Box 749112Atlanta, GA 30374-9112 · (434) 295-1000

Phone(434) 924-1774

Fax(434) 982-6417

Sole ProprietorYes

Medical School CMSEast Carolina University School Of DentistryGraduated 2021

Enumeration DateJune 17, 2020

Last NPPES UpdateApril 9, 20253 updates tracked since enumeration

NPPES CertifiedApril 9, 2025

✔ NPI 1417573312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in VA · 0411000075

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.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 11867 (NC)

Also ListedOral MedicineTaxonomy 125Q00000X · License 0411000075 (VA)

1222 JEFFERSON PARK AVE, Charlottesville, VA 22903

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, 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 and accepts Medicare assignment

Jiwon Lim Dmd, Mph is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193128346

PECOS Enrollment IDI20250410001757

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Virginia Medical Center

Acute Care Hospitals · Charlottesville, VA

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number490009

Location1215 Lee StreetCharlottesville, VA 22908 · Charlottesville City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22903 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

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 20

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

MILAD MEMARI MD

Internal Medicine