Provider Demographics
NPI:1740577873
Name:YOUNG H. KIM AND DOIL KIM DDS INC
Entity Type:Organization
Organization Name:YOUNG H. KIM AND DOIL KIM DDS INC
Other - Org Name:DOIL KIM DDS MMSC ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-383-2080
Mailing Address - Street 1:3663 W 6TH ST
Mailing Address - Street 2:SUITE #207
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3049
Mailing Address - Country:US
Mailing Address - Phone:213-383-2080
Mailing Address - Fax:213-383-2082
Practice Address - Street 1:3663 W 6TH ST
Practice Address - Street 2:SUITE #207
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3049
Practice Address - Country:US
Practice Address - Phone:213-383-2080
Practice Address - Fax:213-383-2082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-10
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA545341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty