Provider Demographics
NPI:1952166779
Name:J LIM DENTAL PLLC
Entity Type:Organization
Organization Name:J LIM DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER
Authorized Official - Prefix:DR
Authorized Official - First Name:JISU
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-201-0312
Mailing Address - Street 1:330 W 58TH ST APT 7M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1815
Mailing Address - Country:US
Mailing Address - Phone:781-201-0312
Mailing Address - Fax:
Practice Address - Street 1:36 E 36TH ST STE 1K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3441
Practice Address - Country:US
Practice Address - Phone:212-532-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty