Provider Demographics
NPI:1144239245
Name:KIM, HYE-JIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HYE-JIN
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4086
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-4086
Mailing Address - Country:US
Mailing Address - Phone:425-457-3639
Mailing Address - Fax:
Practice Address - Street 1:15015 MAIN ST
Practice Address - Street 2:STE 105
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-5229
Practice Address - Country:US
Practice Address - Phone:425-605-3575
Practice Address - Fax:425-605-4522
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0369251223G0001X
WADE000111151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice