Healthcare Provider Details

I. General information

NPI: 1972440899
Provider Name (Legal Business Name): DR. IM DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13034 CHAPMAN AVE
GARDEN GROVE CA
92840-4349
US

IV. Provider business mailing address

13034 CHAPMAN AVE
GARDEN GROVE CA
92840-4349
US

V. Phone/Fax

Practice location:
  • Phone: 714-750-7334
  • Fax:
Mailing address:
  • Phone: 714-750-7334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBIN IM
Title or Position: DENTIST
Credential: DDS
Phone: 714-750-7334