Healthcare Provider Details

I. General information

NPI: 1952257180
Provider Name (Legal Business Name): MINGI KIM DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 DAGGET ST STE 104
SAN DIEGO CA
92111-2235
US

IV. Provider business mailing address

7750 DAGGET ST STE 104
SAN DIEGO CA
92111-2235
US

V. Phone/Fax

Practice location:
  • Phone: 858-874-3000
  • Fax:
Mailing address:
  • Phone: 858-874-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MINGI KIM
Title or Position: OWNER
Credential:
Phone: 858-874-3000