JENNIFER SUJI KIM DMD
NPI 1780207993
Dentist - General Practice in Allendale, NJ

Active since May 21, 2020Opted out of Medicare · through Feb 7, 2028
42 W ALLENDALE AVE, ALLENDALE, NJ 07401(201) 760-1116 Get Directions Write a Review

NPPES record last updated: June 28, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 20, 2021, May 21, 2020 (2 updates tracked since 2020).

About Jennifer Suji Kim Dmd NPPES

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

JENNIFER SUJI KIM DMD (NPI 1780207993) is an individual general practice provider in Allendale, New Jersey, licensed in New Jersey (22DI02835700) and active in the NPI registry since May 2020. She has opted out of Medicare through February 7, 2028 and maintains a secondary practice location in Bronx.

NPPES Registry Identity

NPI1780207993
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameJENNIFER SUJI KIMCredential: DMD
Location Address42 W ALLENDALE AVEAllendale, NJ 07401-1739
Mailing Address770 Anderson Ave Apt 7aCliffside Park, NJ 07010-2163
Sole ProprietorYes
Enumeration DateMay 21, 2020
Last NPPES UpdateJune 28, 20222 updates tracked since enumeration
NPPES CertifiedJune 28, 2022
NPI 1780207993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in NJ · 22DI02835700
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
42 W ALLENDALE AVE, Allendale, NJ 07401

Secondary Practice Location 1

Location 11775 Grand Concourse, BronxCare Health Systems, Dept of Dentistry, 6th floorBronx, NY 10453 · Phone (718) 901-8410

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Jennifer Suji Kim Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 7, 2022 through February 7, 2028.

Opt-Out Effective DateFebruary 7, 2022
Opt-Out In Effect ThroughFebruary 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

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

Dentist
42 W ALLENDALE AVE
ALLENDALE, NJ 07401
Dentist
42 W ALLENDALE AVE
ALLENDALE, NJ 07401
Dentist (General Practice)
42 W ALLENDALE AVE
ALLENDALE, NJ 07401

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 Jennifer Kim's NPI number?

The NPI number for Jennifer Kim is 1780207993. It was assigned to this individual provider in the NPPES registry on May 21, 2020.

Where is Jennifer Kim located?

Jennifer Kim practices at 42 W Allendale Ave, Allendale, NJ 07401. The listed phone number is (201) 760-1116.

What is Jennifer Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jennifer Kim enrolled in Medicare?

No. Jennifer Kim has opted out of Medicare through February 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Jennifer Kim accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Jennifer 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 Jennifer Kim was last updated on June 28, 2022. 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.