Provider Demographics
NPI:1578865937
Name:SIM, CHIEN JOO (DDS)
Entity Type:Individual
Prefix:MS
First Name:CHIEN JOO
Middle Name:
Last Name:SIM
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 1:228 BRAUER HALL
Mailing Address - Street 2:CAMPUS BOX 7450
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-966-2743
Mailing Address - Fax:919-966-7992
Practice Address - Street 1:228 BRAUER HALL
Practice Address - Street 2:PEDIATRIC DENTISTRY, UNC SCHOOL OF DENTISTRY
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-966-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC150813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist