Provider Demographics
NPI:1225209463
Name:KIM, YOOLIM (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:YOOLIM
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7384 S ALTON WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2369
Mailing Address - Country:US
Mailing Address - Phone:303-721-1173
Mailing Address - Fax:303-721-1179
Practice Address - Street 1:7384 S ALTON WAY STE 101
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2369
Practice Address - Country:US
Practice Address - Phone:303-721-1173
Practice Address - Fax:303-721-1179
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-16
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.027116122300000X
IL0210024911223P0300X
CODEN002027121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No122300000XDental ProvidersDentist