Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053981407 Individual Practitioner Male Practitioner

Dr. Jake Kim , DDS

Dentist - General Practice • Lake Dallas, TX

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Jake Kim, DDS is a registered healthcare professional specializing in Dentist - General Practice in Lake Dallas, TX. Official NPI practice address is registered at 507 JEFFERSON LN.

Practice Location & Contact Primary Location

Practice Address

507 Jefferson Ln

Lake Dallas, TX 750653489

Telephone 7034774659
Associated Practice Facility / Clinic
🏢 1010 Emergency Dental Pllc Facility NPI 1730915802

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Lake Dallas, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
1 Specialists

Practicing in Lake Dallas, TX (10570 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: 2024-11-24
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 39478

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.

Career & Practice History Timeline

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

12 Historical Events
📍
Updated Practice Location November 24, 2024

Registered at 507 JEFFERSON LN, LAKE DALLAS, TX 750653489 (Tel: 7034774659)

📍
Updated Business Mailing Address November 24, 2024

Registered at 507 JEFFERSON LN, LAKE DALLAS, TX 750653489 (Tel: 7034774659)

📍
Updated Practice Location October 29, 2024

Registered at 4251 FM 2181 STE 264, CORINTH, TX 762104220 (Tel: 9404973000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 29, 2024

Dentist (License #39478 in TX)

📍
Updated Practice Location June 10, 2022

Registered at 9648 CHAPEL HILL RD STE 100, MORRISVILLE, NC 275607846 (Tel: 9193223588)

👤
Provider Name / Credentials Updated June 10, 2022

Recorded as JAKE KIM, DDS

NPI Profile Active June 28, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 28, 2021

Registered at 135 MAIN ST, DANBURY, CT 068107843 (Tel: 2034562064)

📍
Updated Business Mailing Address June 28, 2021

Registered at 435 3RD ST, PALISADES PARK, NJ 076501748 (Tel: 7034774659)

👤
Provider Name / Credentials Updated June 28, 2021

Recorded as JAE IK KIM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 28, 2021

Dentist (License #13172 in CT)

🟢
Initial NPI Registration & Enumeration June 28, 2021

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: 1053981407
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 28, 2021
Last Update: November 24, 2024
Sole Proprietor: No

Mailing Address

507 Jefferson Ln

Lake Dallas, TX 750653489

Phone: 7034774659

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.