Provider Demographics
NPI:1700919248
Name:KIM, JAMES W (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:3971 IRVINE BLVD
Mailing Address - Street 2:STE. 102
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2482
Mailing Address - Country:US
Mailing Address - Phone:714-368-3319
Mailing Address - Fax:714-368-3499
Practice Address - Street 1:3971 IRVINE BLVD
Practice Address - Street 2:STE. 102
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-2482
Practice Address - Country:US
Practice Address - Phone:714-368-3319
Practice Address - Fax:714-368-3499
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA436171223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics