Provider Demographics
NPI:1720215528
Name:KIM, JOYCE C (DDS)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:C
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 1:15455 JEFFREY RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4100
Mailing Address - Country:US
Mailing Address - Phone:949-653-2828
Mailing Address - Fax:
Practice Address - Street 1:15455 JEFFREY RD
Practice Address - Street 2:SUITE 310
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4100
Practice Address - Country:US
Practice Address - Phone:949-653-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44412122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist