Provider Demographics
NPI:1144749722
Name:JOO B. YIM, DDS, INC
Entity Type:Organization
Organization Name:JOO B. YIM, DDS, INC
Other - Org Name:HAPPY SMILE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOO BIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-775-1200
Mailing Address - Street 1:10178 RESEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1487
Mailing Address - Country:US
Mailing Address - Phone:818-775-1200
Mailing Address - Fax:818-775-5789
Practice Address - Street 1:10178 RESEDA BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-1487
Practice Address - Country:US
Practice Address - Phone:818-775-1200
Practice Address - Fax:818-775-5789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty