Provider Demographics
NPI:1265067342
Name:RYAN H. YIM, DDS LLC
Entity type:Organization
Organization Name:RYAN H. YIM, DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:HON LEONG
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-955-1506
Mailing Address - Street 1:1441 KAPIOLANI BLVD STE 1506
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4407
Mailing Address - Country:US
Mailing Address - Phone:808-955-1506
Mailing Address - Fax:808-955-1551
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1506
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4407
Practice Address - Country:US
Practice Address - Phone:808-955-1506
Practice Address - Fax:808-955-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty