Provider Demographics
NPI:1790524775
Name:KIM, NATHAN HYUN-MIN (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:HYUN-MIN
Last Name:KIM
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 1:6638 MAHOGANY DR
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-8055
Mailing Address - Country:US
Mailing Address - Phone:614-906-4464
Mailing Address - Fax:
Practice Address - Street 1:1010 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1908
Practice Address - Country:US
Practice Address - Phone:614-461-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0274861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice