Provider Demographics
NPI:1326317371
Name:KIM, YOO KON (DDS)
Entity Type:Individual
Prefix:DR
First Name:YOO KON
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6295 BISSONNET ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-6809
Mailing Address - Country:US
Mailing Address - Phone:713-777-1313
Mailing Address - Fax:713-777-4242
Practice Address - Street 1:6295 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-6809
Practice Address - Country:US
Practice Address - Phone:713-777-1313
Practice Address - Fax:713-777-4242
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist