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NPI Code Detail

MEDICARE: LINDA H KIM DDS

MEDICARE: LINDA H KIM DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12010017AIN

General Provider Information

NPI Number : 1366550121
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA H KIM DDS
Provider Business Mailing Address
First Line : 11856 LEDGESTONE CIR
Second Line :
City : FISHERS
State : IN
Zip : 46037-8437
Country : US
Telephone Number : 317-570-7765
Fax Number :
Provider Business Practice Location Address
First Line : 3838 N RURAL ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2930
Country : US
Telephone Number : 317-221-2306
Fax Number : 317-221-2336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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Directions to “ LINDA H KIM DDS” Practice Location

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