Healthcare Provider Details

I. General information

NPI: 1639926983
Provider Name (Legal Business Name): SAEHEE A. KIM DMD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 CUESTA DR STE 130
MOUNTAIN VIEW CA
94040-3765
US

IV. Provider business mailing address

777 CUESTA DR STE 130
MOUNTAIN VIEW CA
94040-3765
US

V. Phone/Fax

Practice location:
  • Phone: 425-263-7447
  • Fax:
Mailing address:
  • Phone: 425-263-7447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: SAEHEE KIM
Title or Position: OWNER
Credential: DMD
Phone: 425-263-7447