Provider Demographics
NPI:1407084999
Name:KIM, KYUNG MIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:MIN
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:255 N SIERRA ST
Mailing Address - Street 2:UNIT 819
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1349
Mailing Address - Country:US
Mailing Address - Phone:551-206-9403
Mailing Address - Fax:
Practice Address - Street 1:6490 S MCCARRAN BLVD
Practice Address - Street 2:SUITE A-9
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6165
Practice Address - Country:US
Practice Address - Phone:775-284-4545
Practice Address - Fax:775-284-4550
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVS6-114C1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry