Provider Demographics
NPI:1225415441
Name:KIM, EUNICE YOON SUK (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:YOON SUK
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 1:1150 RIPLEY ST APT 1602
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-7434
Mailing Address - Country:US
Mailing Address - Phone:443-979-3464
Mailing Address - Fax:
Practice Address - Street 1:804 PERSHING DR STE 102
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4436
Practice Address - Country:US
Practice Address - Phone:301-218-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00013781223G0001X
MD168701223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice