Provider Demographics
NPI:1801192208
Name:J.LIM DENTAL CORPORATION
Entity Type:Organization
Organization Name:J.LIM DENTAL CORPORATION
Other - Org Name:POWAY COAST DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JHANG
Authorized Official - Middle Name:H
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-486-3300
Mailing Address - Street 1:13569 POWAY RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4715
Mailing Address - Country:US
Mailing Address - Phone:858-486-3300
Mailing Address - Fax:858-486-5300
Practice Address - Street 1:13569 POWAY RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4715
Practice Address - Country:US
Practice Address - Phone:858-486-3300
Practice Address - Fax:858-486-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty