Healthcare Provider Details

I. General information

NPI: 1780525717
Provider Name (Legal Business Name): ANDREW JIHO LIM DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 5TH ST
SAN FRANCISCO CA
94103
US

IV. Provider business mailing address

900 FOLSOM ST APT 459
SAN FRANCISCO CA
94107-2172
US

V. Phone/Fax

Practice location:
  • Phone: 858-776-9178
  • Fax:
Mailing address:
  • Phone: 959-776-9178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: