Provider Demographics
NPI:1184847667
Name:IM, HELEN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:H
Last Name:IM
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 1:28780 SINGLE OAK DR STE 150
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5528
Mailing Address - Country:US
Mailing Address - Phone:951-695-0010
Mailing Address - Fax:951-695-0024
Practice Address - Street 1:28780 SINGLE OAK DR STE 150
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5528
Practice Address - Country:US
Practice Address - Phone:951-695-0010
Practice Address - Fax:951-695-0024
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA401181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice