Provider Demographics
NPI:1922125863
Name:AUH, KILPYUNG (DDS)
Entity Type:Individual
Prefix:
First Name:KILPYUNG
Middle Name:
Last Name:AUH
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 1:22225 STEEPLECHASE LN
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3636
Mailing Address - Country:US
Mailing Address - Phone:909-861-3850
Mailing Address - Fax:
Practice Address - Street 1:3400 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-5217
Practice Address - Country:US
Practice Address - Phone:323-734-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice