Provider Demographics
NPI:1720501034
Name:LOH, JI KIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JI
Middle Name:KIN
Last Name:LOH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 W ARBY AVE UNIT 326
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-4659
Mailing Address - Country:US
Mailing Address - Phone:408-655-6208
Mailing Address - Fax:
Practice Address - Street 1:7181 N HUALAPAI WAY STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-1116
Practice Address - Country:US
Practice Address - Phone:702-852-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV69681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice