Provider Demographics
NPI:1255084422
Name:DREAM HIGH DENTAL ANESTHESIA, LLC
Entity type:Organization
Organization Name:DREAM HIGH DENTAL ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST ANESTHESIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-296-2338
Mailing Address - Street 1:1979 HILLMAN ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-1601
Mailing Address - Country:US
Mailing Address - Phone:559-732-4279
Mailing Address - Fax:
Practice Address - Street 1:144 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-1604
Practice Address - Country:US
Practice Address - Phone:475-422-8761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDental AnesthesiologyGroup - Single Specialty