# DR. JAY D KIM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891920575
- **Gender:** Man
- **Credential:** DMD, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 058413 | NY | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | P69669 LIMITEDPERMIT | NY | — |

## Other

- **Enumeration date:** 05/25/2009
- **Last updated:** 10/12/2020