Provider Demographics
NPI:1497183065
Name:CHRISTOPHER J. KIM, DDS, INC.
Entity Type:Organization
Organization Name:CHRISTOPHER J. KIM, DDS, INC.
Other - Org Name:MOUNTAIN VIEW DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JUNG KWON
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, ME
Authorized Official - Phone:650-559-8882
Mailing Address - Street 1:2486 W. EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-559-8882
Mailing Address - Fax:650-559-8887
Practice Address - Street 1:2486 W. EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-559-8882
Practice Address - Fax:650-559-8887
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTOPHER J. KIM, DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43802122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty