Provider Demographics
NPI:1154076875
Name:HYUN W KIM DDS INC
Entity Type:Organization
Organization Name:HYUN W KIM DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:WOO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-810-2782
Mailing Address - Street 1:19250 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3004
Mailing Address - Country:US
Mailing Address - Phone:626-810-2782
Mailing Address - Fax:
Practice Address - Street 1:19250 COLIMA RD
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3004
Practice Address - Country:US
Practice Address - Phone:626-810-2782
Practice Address - Fax:626-964-0842
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HYUN W KIM DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty