Provider Demographics
NPI:1457529331
Name:KIM, JAIBUM (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JAIBUM
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 COMMERCIAL CENTER BLVD
Mailing Address - Street 2:SUITE J220
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6410
Mailing Address - Country:US
Mailing Address - Phone:281-394-2520
Mailing Address - Fax:
Practice Address - Street 1:2717 COMMERCIAL CENTER BLVD
Practice Address - Street 2:SUITE J220
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6410
Practice Address - Country:US
Practice Address - Phone:281-394-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry