Provider Demographics
NPI:1801906813
Name:KIM, ANTHONY SUNG GIL (DMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:SUNG GIL
Last Name:KIM
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 1:41-1347 KALANIANAOLE HWY
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1247
Mailing Address - Country:US
Mailing Address - Phone:808-259-5466
Mailing Address - Fax:808-954-7144
Practice Address - Street 1:41-1347 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1247
Practice Address - Country:US
Practice Address - Phone:808-259-5466
Practice Address - Fax:808-954-7144
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT23261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice