Provider Demographics
NPI:1790875284
Name:MUIR, KYUNGIEE GINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYUNGIEE
Middle Name:GINA
Last Name:MUIR
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 1:10727 WHITE OAK AVENUE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344
Mailing Address - Country:US
Mailing Address - Phone:818-363-0300
Mailing Address - Fax:818-363-7656
Practice Address - Street 1:10727 WHITE OAK AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4631
Practice Address - Country:US
Practice Address - Phone:818-363-0300
Practice Address - Fax:818-363-7656
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist