Provider Demographics
NPI:1134417223
Name:KIM, ESTHER YOUNG (DDS)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:YOUNG
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 1:417 E 65TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6955
Mailing Address - Country:US
Mailing Address - Phone:410-718-0011
Mailing Address - Fax:
Practice Address - Street 1:4234 BRONX BLVD FRNT 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2669
Practice Address - Country:US
Practice Address - Phone:347-341-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program