Provider Demographics
NPI:1841578671
Name:KIM, BEUM KYEU (DDS)
Entity Type:Individual
Prefix:DR
First Name:BEUM KYEU
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PHIPPS BLVD NE
Mailing Address - Street 2:1910
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-3336
Mailing Address - Country:US
Mailing Address - Phone:917-557-4378
Mailing Address - Fax:
Practice Address - Street 1:600 PHIPPS BLVD NE
Practice Address - Street 2:1910
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-3336
Practice Address - Country:US
Practice Address - Phone:917-557-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN031501223G0001X
IL019.0287101223G0001X
GADN0153191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice