Provider Demographics
NPI:1942432224
Name:KIM, SOYEON MONICA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOYEON
Middle Name:MONICA
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 1:440 SYLVAN AVE STE 133
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2736
Mailing Address - Country:US
Mailing Address - Phone:201-568-8732
Mailing Address - Fax:201-568-8735
Practice Address - Street 1:440 SYLVAN AVE STE 133
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2736
Practice Address - Country:US
Practice Address - Phone:201-568-8732
Practice Address - Fax:201-568-8735
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI19294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist