Provider Demographics
NPI:1649375171
Name:RHEE, JIM SUNG HO (DDS)
Entity type:Individual
Prefix:MR
First Name:JIM
Middle Name:SUNG HO
Last Name:RHEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 N EL CAMINO REAL STE C210
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1355
Mailing Address - Country:US
Mailing Address - Phone:760-634-6605
Mailing Address - Fax:760-943-7757
Practice Address - Street 1:477 N EL CAMINO REAL STE C210
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1355
Practice Address - Country:US
Practice Address - Phone:760-943-8880
Practice Address - Fax:760-943-7757
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47557122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist