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Active NPI 1568936763 Individual Practitioner Male Practitioner

Dr. Jisu Kim , DDS

Dentist • Honolulu, HI

Professional Overview & Biography Verified Profile Summary

Dr. Jisu Kim, DDS is a registered healthcare professional specializing in Dentist in Honolulu, HI. Practice services are available at 1070 N KING ST STE 207 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1070 N King St Ste 207

Honolulu, HI 968174584

Telephone 8084997924
Associated Practice Facility / Clinic
🏢 Sungshim Dental Inc Facility NPI 1275366155

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Honolulu, HI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.0 Yrs
State Avg: 6.0 Yrs
Regional Practice Density
158 Specialists

Practicing in Honolulu, HI (445 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: 2024-09-22
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License HI DT-2882

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 DE60997067

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 TX 35909

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 PA DS040530

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 CT 12444

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.

Career & Practice History Timeline

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

13 Historical Events
📍
Updated Practice Location September 22, 2024

Registered at 1070 N KING ST STE 207, HONOLULU, HI 968174584 (Tel: 8084997924)

📍
Updated Business Mailing Address September 22, 2024

Registered at 1070 N KING ST STE 207, HONOLULU, HI 968174584 (Tel: 8084997924)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 22, 2024

Dentist (License #DE60997067 in WA)

📍
Updated Practice Location March 26, 2021

Registered at 1441 KAPIOLANI BLVD, STE 1405 ATTN: JISU KIM, HONOLULU, HI 96814 (Tel: 6125478546)

📍
Updated Business Mailing Address March 26, 2021

Registered at 1441 KAPIOLANI BLVD, STE 1405 ATTN: JISU KIM, HONOLULU, HI 96814 (Tel: 6125478546)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2021

Dentist (License #DT-2882 in HI)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2019

Dentist (License #12444 in CT)

NPI Profile Active January 22, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location January 22, 2019

Registered at SANDONG-MYEON WONCHON1 GIL 13-5, SANDONG BRANCH OFFICE OF GURYE-GUN PUBLIC HEALTH CENTER, GURYE, JEOLLANAMD 57602 (Tel: 6125478546)

📍
Updated Business Mailing Address January 22, 2019

Registered at 212 W 91ST ST APT 515, NEW YORK, NY 100241339 (Tel: 6125478546)

👤
Provider Name / Credentials Updated January 22, 2019

Recorded as JISU KIM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 22, 2019

Dentist (License #DS040530 in PA)

🟢
Initial NPI Registration & Enumeration January 22, 2019

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: 1568936763
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 22, 2019
Last Update: September 22, 2024
Sole Proprietor: Yes

Mailing Address

1070 N King St Ste 207

Honolulu, HI 968174584

Phone: 8084997924

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.