Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1780207993 Deactivated / Inactive NPI Female Practitioner

Dr. Jennifer Suji Kim , DMD

Dentist - General Practice • Allendale, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jennifer Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 21, 2020
NPI Deactivation Date August 01, 2021
Total Practice Duration ~1 Years of Practice (2020 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Jennifer Kim, DMD was a registered Dentist - General Practice practicing in Allendale, NJ. Throughout an active medical career spanning 1 years, Dr. Kim provided care at the practice location at 42 W ALLENDALE AVE until profile deactivation on 2021-08-01.

Practice Location & Contact Primary Location

Practice Address

42 W Allendale Ave

Allendale, NJ 074011739

Telephone 2017601116
Associated Practice Facility / Clinic
🏢 Luisa Milo Dds Llc Facility NPI 1275620213

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Allendale, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.1 Yrs
Regional Practice Density
2 Specialists

Practicing in Allendale, NJ (4316 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: 2022-06-28
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NJ 22DI02835700

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.

Secondary Practice Locations

1775 Grand Concourse, Bronxcare Health Systems, Dept Of Dentistry, 6th Floor

Bronx, NY 10453

Phone: 7189018410

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1326734724

Doctor of Dental Medicine

Dr. John Saraydarian , DMD

Dentist - General Practice

NPI 1477569697

Doctor of Dental Medicine

Career & Practice History Timeline

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

14 Historical Events
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Updated Practice Location June 28, 2022

Registered at 42 W ALLENDALE AVE, ALLENDALE, NJ 074011739 (Tel: 2017601116)

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Updated Business Mailing Address June 28, 2022

Registered at 770 ANDERSON AVE APT 7A, CLIFFSIDE PARK, NJ 070102163

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 28, 2022

Dentist (License #22DI02835700 in NJ)

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Updated Practice Location August 20, 2021

Registered at 1775 GRAND CONCOURSE, BRONXCARE HEALTH SYSTEMS, DEPT OF DENTISTRY, 6TH FLOOR, BRONX, NY 10453 (Tel: 7189018410)

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Updated Business Mailing Address August 20, 2021

Registered at 5 SUMMIT ST, ENGLEWOOD CLIFFS, NJ 076321443

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Provider Name / Credentials Updated August 20, 2021

Recorded as JENNIFER KIM, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 20, 2021

Student in an Organized Health Care Education/Training Program

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NPI Profile Deactivated August 01, 2021

Record deactivated on August 01, 2021

NPI Profile Active May 21, 2020

NPI status registered as active in NPPES database

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Updated Practice Location May 21, 2020

Registered at 1775 GRAND CONCOURSE, BRONXCARE HEALTH SYSTEMS, DEPT OF DENTISTRY, 6TH FLOOR, BRONX, NY 10453 (Tel: 7189018410)

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Updated Business Mailing Address May 21, 2020

Registered at 5 SUMMIT ST, ENGLEWOOD CLIFFS, NJ 076321443

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Provider Name / Credentials Updated May 21, 2020

Recorded as JENNIFER KIM, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 21, 2020

Student in an Organized Health Care Education/Training Program

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Initial NPI Registration & Enumeration May 21, 2020

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: 1780207993
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2020
Last Update: June 28, 2022
Deactivation Date: August 01, 2021
Sole Proprietor: Yes

Mailing Address

770 Anderson Ave Apt 7a

Cliffside Park, NJ 070102163

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.