Provider Demographics
NPI:1417138181
Name:YONG AND KIM DENTAL CORP.
Entity Type:Organization
Organization Name:YONG AND KIM DENTAL CORP.
Other - Org Name:YONG & KIM DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JUNG
Authorized Official - Last Name:YONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-535-0192
Mailing Address - Street 1:101 E LINCOLN AVE
Mailing Address - Street 2:STE.100
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3202
Mailing Address - Country:US
Mailing Address - Phone:714-535-0192
Mailing Address - Fax:
Practice Address - Street 1:101 E LINCOLN AVE
Practice Address - Street 2:STE.100
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3202
Practice Address - Country:US
Practice Address - Phone:714-535-0192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA475911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty