Provider Demographics
NPI:1235352071
Name:LIM, JOSEPH DAEKEUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAEKEUN
Last Name:LIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 W CARSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-7128
Mailing Address - Country:US
Mailing Address - Phone:310-320-8797
Mailing Address - Fax:310-320-5446
Practice Address - Street 1:2275 W CARSON ST STE B
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-7128
Practice Address - Country:US
Practice Address - Phone:310-320-8797
Practice Address - Fax:310-320-5446
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA487431223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics