Provider Demographics
NPI:1538464771
Name:KIM, HYUN-JUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HYUN-JUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 SANTA BARBARA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-0808
Mailing Address - Country:US
Mailing Address - Phone:949-933-9914
Mailing Address - Fax:
Practice Address - Street 1:1518 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1928
Practice Address - Country:US
Practice Address - Phone:714-998-8998
Practice Address - Fax:714-998-0771
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA595561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice