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Active NPI 1982974135 Individual Practitioner Male Practitioner

Dr. Jeffrey Mark Kim , DDS

Dentist - Periodontics • Port Orange, FL

Professional Overview & Biography Verified Profile Summary

Dr. Jeffrey Kim, DDS is a registered healthcare professional specializing in Dentist - Periodontics in Port Orange, FL. Practice services are available at 4570 S CLYDE MORRIS BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4570 S Clyde Morris Blvd
Suite 1

Port Orange, FL 321295401

Telephone 3863224867
Fax 3863223899
Associated Practice Facility / Clinic
🏢 J. Kim Periodontics, Llc Facility NPI 1629198551

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Periodontics in Port Orange, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 37.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Port Orange, FL (507 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - Periodontics Primary Specialty

NUCC Taxonomy Code: 1223P0300X

State License FL DN13917

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State License Number
DN13917 (FL)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active January 05, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location January 05, 2012

Registered at 4570 S CLYDE MORRIS BLVD, SUITE 1, PORT ORANGE, FL 321295401 (Tel: 3863224867)

📍
Updated Business Mailing Address January 05, 2012

Registered at 4570 S CLYDE MORRIS BLVD, SUITE 1, PORT ORANGE, FL 321295401

👤
Provider Name / Credentials Updated January 05, 2012

Recorded as JEFFREY KIM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2012

Dentist (License #DN13917 in FL)

🟢
Initial NPI Registration & Enumeration January 05, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982974135
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 05, 2012
Last Update: January 05, 2012
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

4570 S Clyde Morris Blvd, Suite 1

Port Orange, FL 321295401

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.