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J. KIM PERIODONTICS, LLC
NPI 1629198551
Dentist - Periodontics in Port Orange, FL

Active since April 02, 2007
4570 S CLYDE MORRIS BLVD, SUITE 1, PORT ORANGE, FL 32129(386) 322-4867 Get Directions Write a Review

NPPES record last updated: September 28, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About J. Kim Periodontics, Llc NPPES

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

J. KIM PERIODONTICS, LLC (NPI 1629198551) is a healthcare organization registered as a periodontics in Port Orange, Florida and active in the NPI registry since April 2007. The organization lists Jeffrey M Kim, Owner, as its authorized official.

NPPES Registry Identity

NPI1629198551
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameJ. KIM PERIODONTICS, LLC
Location Address4570 S CLYDE MORRIS BLVD, SUITE 1Port Orange, FL 32129-5401
Mailing Address4570 S Clyde Morris Blvd, Suite 1Port Orange, FL 32129-5401 · (386) 322-4867
Phone(386) 322-4867
Organization SubpartNo
Authorized OfficialJeffrey M KimOwner · (386) 322-4867
Enumeration DateApril 2, 2007
Last NPPES UpdateSeptember 28, 2007
✔ NPI 1629198551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in FL · DN13917
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
4570 S CLYDE MORRIS BLVD, Port Orange, FL 32129
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

JEFFREY MARK KIM DDS
Dentist (Periodontics)
4570 S CLYDE MORRIS BLVD, SUITE 1
PORT ORANGE, FL 32129
Volusia County (386) 322-4867

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 J. Kim Periodontics, LLC's NPI number?

The NPI number for J. Kim Periodontics, LLC is 1629198551. It was assigned to this organization in the NPPES registry on April 2, 2007.

Where is J. Kim Periodontics, LLC located?

J. Kim Periodontics, LLC is located at 4570 S Clyde Morris Blvd Suite 1, Port Orange, FL 32129. The listed phone number is (386) 322-4867.

What is J. Kim Periodontics, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for J. Kim Periodontics, LLC was last updated on September 28, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.