Provider Demographics
NPI:1942752969
Name:JOSEPH S KIM, DMD, INC
Entity Type:Organization
Organization Name:JOSEPH S KIM, DMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:650-938-9280
Mailing Address - Street 1:700 E EL CAMINO REAL STE 220
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2813
Mailing Address - Country:US
Mailing Address - Phone:650-938-9280
Mailing Address - Fax:650-938-9282
Practice Address - Street 1:700 E EL CAMINO REAL STE 220
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2813
Practice Address - Country:US
Practice Address - Phone:650-938-9280
Practice Address - Fax:650-938-9282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA439931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty