Provider Demographics
NPI:1851553259
Name:KIM, KATHERINE K (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:K
Last Name:KIM
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 1:45 LUDLOW ST STE 410
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1949
Mailing Address - Country:US
Mailing Address - Phone:914-400-2000
Mailing Address - Fax:914-556-2222
Practice Address - Street 1:45 LUDLOW ST STE 410
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705
Practice Address - Country:US
Practice Address - Phone:914-400-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0526341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics