Provider Demographics
NPI:1669627790
Name:KIM, ALEXANDER JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JEFFREY
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E REMINGTON DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1934
Mailing Address - Country:US
Mailing Address - Phone:408-446-5789
Mailing Address - Fax:408-446-1447
Practice Address - Street 1:425 E REMINGTON DR STE 3
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1934
Practice Address - Country:US
Practice Address - Phone:408-446-5789
Practice Address - Fax:408-446-1447
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516011223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics