Healthcare Provider Details

I. General information

NPI: 1548186505
Provider Name (Legal Business Name): SOLANA DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 E FOOTHILL BLVD
UPLAND CA
91786-4054
US

IV. Provider business mailing address

144 WATERFALL LN
BREA CA
92821-4348
US

V. Phone/Fax

Practice location:
  • Phone: 510-926-9414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAEUK KIM
Title or Position: CEO
Credential: DDS
Phone: 510-926-9414