Provider Demographics
NPI:1780230946
Name:STEVE J. KIM, DDS, PLLC
Entity Type:Organization
Organization Name:STEVE J. KIM, DDS, PLLC
Other - Org Name:CUSTER CREEK DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:JAEWOO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-821-0187
Mailing Address - Street 1:3041 S. CUSTER RD.
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:469-343-1212
Mailing Address - Fax:469-343-1234
Practice Address - Street 1:3041 S. CUSTER RD.
Practice Address - Street 2:SUITE 600
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:469-343-1212
Practice Address - Fax:469-343-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental