Provider Demographics
NPI:1801023734
Name:REYES, HENNA KIM (DMD)
Entity Type:Individual
Prefix:DR
First Name:HENNA
Middle Name:KIM
Last Name:REYES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-4102
Mailing Address - Country:US
Mailing Address - Phone:949-697-3232
Mailing Address - Fax:
Practice Address - Street 1:500 E COLORADO ST # 200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1607
Practice Address - Country:US
Practice Address - Phone:949-697-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics