Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jin Moo Kim

Individual provider Dentist · NPI 1104619360

Jin Moo Kim is a Dentist in Conyers, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2025

Practice location Address checks out

1450 Highway 138 SE
Conyers, GA 30013-1285
Phone: (678) 521-9727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D123926 (GA)

Record details

NPI number1104619360
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 28, 2025
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025
Mailing address8510 Saint Marlo Fairway Dr, Duluth, GA 30097-6602

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