Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083084404 Individual Practitioner Male Practitioner

Dr. Jonathan Kim , DDS

Dentist • Snellville, GA

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Kim, DDS is a registered healthcare professional specializing in Dentist in Snellville, GA. Practice services are available at 1830 SCENIC HWY N STE 220 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1830 Scenic Hwy N Ste 220

Snellville, GA 300782100

Telephone 7708449454
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Snellville, GA

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

Practicing in Snellville, 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: 2022-10-01
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License GA DN122806

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License CA 65136

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License WA 60793892

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.

Secondary Practice Locations

27289 Willow Leaf Rd

Moreno Valley, CA 925554755

Phone: 6783616213

Practice Associates & Co-Workers

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

5 Associated Practitioners
Dr. Hani Patel , DDS

Dentist - General Practice

NPI 1114818853

Doctor of Dental Surgery

NPI 1346813227

Doctor of Dental Medicine

NPI 1407416654

Doctor of Dental Medicine

Nazam Lakhani

Dentist - General Practice

NPI 1669154902
NPI 1740772128

Doctor of Dental Medicine

Career & Practice History Timeline

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

11 Historical Events
📍
Updated Practice Location October 01, 2022

Registered at 1830 SCENIC HWY N STE 220, SNELLVILLE, GA 300782100 (Tel: 7708449454)

📍
Updated Business Mailing Address October 01, 2022

Registered at 4323 TACOMA TRCE, SUWANEE, GA 300248731 (Tel: 6783616213)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2022

Dentist (License #65136 in CA)

📍
Updated Business Mailing Address April 16, 2018

Registered at 18822 CHATFIELD DR, RIVERSIDE, CA 925089312 (Tel: 6783616213)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2018

Dentist (License #60793892 in WA)

NPI Profile Active September 28, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 28, 2015

Registered at 27289 WILLOW LEAF RD, MORENO VALLEY, CA 925554755 (Tel: 6783616213)

📍
Updated Business Mailing Address September 28, 2015

Registered at 27289 WILLOW LEAF RD, MORENO VALLEY, CA 925554755

👤
Provider Name / Credentials Updated September 28, 2015

Recorded as JONATHAN KIM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2015

Dentist (License #65136 in CA)

🟢
Initial NPI Registration & Enumeration September 28, 2015

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: 1083084404
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 28, 2015
Last Update: October 01, 2022
Sole Proprietor: Yes

Mailing Address

4323 Tacoma Trce

Suwanee, GA 300248731

Phone: 6783616213

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.