Provider Demographics
NPI:1578947123
Name:HKDDS SMILE, PLLC
Entity Type:Organization
Organization Name:HKDDS SMILE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-300-0506
Mailing Address - Street 1:13048 RESEARCH BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3205
Mailing Address - Country:US
Mailing Address - Phone:512-257-2828
Mailing Address - Fax:512-257-2831
Practice Address - Street 1:13048 RESEARCH BLVD
Practice Address - Street 2:STE B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3205
Practice Address - Country:US
Practice Address - Phone:512-257-2828
Practice Address - Fax:512-257-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty