NPI age
15 years
Enumerated 2010-10-20
● Active
Type 1 · Individual
Jungwon Kim, DDS
Kim is 1 of 17 dentist providers in Suwanee and 1 of 539 in Georgia.
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
GA, WA
2 states
Status
Active
No deactivations on record
Last NPPES update
2021-07-12
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 539 active dentist providers in Georgia.
NPI age
15 years
≈ at median (16 yr)
State licenses
2 states
Top 88% — 11% of peers are multi-state
Subspecialties
0
26% of peers hold subspecialties
NPI lifetime · 2010 → 2026
2010-10Enumerated in NPPES
2010
2026
Where they practice
Practice location
350 Town Center Ave
Suwanee, GA 300246914
Mailing address
1922 Shenley Park Ln
Duluth, GA 300974942
Additional practice locations
1 secondary location on file with NPPES.
Location 2
16810 Meridian E
Puyallup, WA 983759604
Specialties
-
Dentist PrimaryAn age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Practice context
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.