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JAEWON KIM

Periodontics · OKLAHOMA CITY, OK

Individual Active Opted out of Medicare NPI 1558032995

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Periodontics1223P0300X✓F-021OK

Medicare eligibility

Part B
Yes
DME
Yes
Home health
Yes
Power mobility
No
Hospice
Yes

Opted out of Medicare (Periodontics), effective 2026-05-14 through 2028-05-14.

Other Periodontics providers in Oklahoma

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.

JAEWON KIM — NPI 1558032995