Provider Demographics
NPI:1558765438
Name:JIN YOUNG KIM, D.D.S., INC.
Entity Type:Organization
Organization Name:JIN YOUNG KIM, D.D.S., INC.
Other - Org Name:NOA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-560-1114
Mailing Address - Street 1:23922 SUMMERHILL LANE
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354
Mailing Address - Country:US
Mailing Address - Phone:661-857-7662
Mailing Address - Fax:
Practice Address - Street 1:23922 SUMMERHILL LN
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354
Practice Address - Country:US
Practice Address - Phone:661-857-7662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA608841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty