Healthcare Provider Details

I. General information

NPI: 1518424068
Provider Name (Legal Business Name): HJKIM DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 N BROOKHURST ST
ANAHEIM CA
92801-1702
US

IV. Provider business mailing address

112 COURTYARD DR
HILLSBOROUGH NJ
08844-4260
US

V. Phone/Fax

Practice location:
  • Phone: 714-533-0303
  • Fax:
Mailing address:
  • Phone: 908-533-4386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. NIKHIL SAHA
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 908-533-4386