Provider Demographics
NPI:1336618503
Name:KIM & AU-YEUNG DENTISTRY, P.C.
Entity Type:Organization
Organization Name:KIM & AU-YEUNG DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG EUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-540-3982
Mailing Address - Street 1:8354 LITTLE EAGLE CT STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-3822
Mailing Address - Country:US
Mailing Address - Phone:317-209-3000
Mailing Address - Fax:
Practice Address - Street 1:8354 LITTLE EAGLE CT STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46234-3822
Practice Address - Country:US
Practice Address - Phone:317-540-3982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-17
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental