Provider Demographics
NPI:1427367226
Name:KIM, JOHN HYUNYOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HYUNYOUNG
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 1:19742 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2432
Mailing Address - Country:US
Mailing Address - Phone:949-748-3722
Mailing Address - Fax:949-502-8855
Practice Address - Street 1:19742 MACARTHUR BLVD
Practice Address - Street 2:SUITE 224
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2432
Practice Address - Country:US
Practice Address - Phone:949-748-3722
Practice Address - Fax:949-502-8855
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53915122300000X
MD13547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist