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NPI Code Detail

MEDICARE: HORIZON MODERN DENTISTRY AND ORTHODONTICS, LLP

MEDICARE: HORIZON MODERN DENTISTRY AND ORTHODONTICS, LLP
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 Dentistry

General Provider Information

NPI Number : 1922314202
Entity Type Code : Organization
Provider Name (Legal Business Name) : HORIZON MODERN DENTISTRY AND ORTHODONTICS, LLP
Provider Business Mailing Address
First Line : 17000 RED HILL AVE
Second Line :
City : IRVINE
State : CA
Zip : 92614-5626
Country : US
Telephone Number : 714-845-8890
Fax Number : 949-474-1495
Provider Business Practice Location Address
First Line : 14858 N FRANK LLOYD WRIGHT BLVD STE 165A
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-2216
Country : US
Telephone Number : 480-860-4455
Fax Number : 480-860-5615
Authorized Official
Title or Position : OWNER /DDS
Name : DR. SEAN Y KIM
Credential : DDS
Telephone Number : 480-860-4455
Provider Enumeration Date : 08/25/2010
Last Update Date : 12/31/2013

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