Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104619360 Individual Practitioner Male Practitioner

Jin Moo Kim

Dentist • Conyers, GA

Professional Overview & Biography Verified Profile Summary

Jin Kim is a registered healthcare professional specializing in Dentist in Conyers, GA. Practice services are available at 1450 HIGHWAY 138 SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1450 Highway 138 Se

Conyers, GA 300131285

Telephone 6785219727
Associated Practice Facility / Clinic
🏢 Pkr Dental Llc Facility NPI 1841656246

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Conyers, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.3 Yrs
Regional Practice Density
33 Specialists

Practicing in Conyers, GA (2164 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

CMS Verified: 2025-08-11
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License GA D123926

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Alexis Irby , DMD

Dentist - General Practice

NPI 1124540224

Doctor of Dental Medicine

Career & Practice History Timeline

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

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2025

Dentist (License #D123926 in GA)

NPI Profile Active May 28, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location May 28, 2025

Registered at 1450 HIGHWAY 138 SE, CONYERS, GA 300131285 (Tel: 6785219727)

📍
Updated Business Mailing Address May 28, 2025

Registered at 8510 SAINT MARLO FAIRWAY DR, DULUTH, GA 300976602 (Tel: 6785219727)

👤
Provider Name / Credentials Updated May 28, 2025

Recorded as JIN KIM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2025

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 28, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jin Kim. Be the first to share your experience!

Sign in to leave a review for Jin Kim

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1104619360
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 28, 2025
Last Update: August 11, 2025
Sole Proprietor: Yes

Mailing Address

8510 Saint Marlo Fairway Dr

Duluth, GA 300976602

Phone: 6785219727

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.