Healthcare Provider Details

I. General information

NPI: 1780040402
Provider Name (Legal Business Name): CHRISTOPHER EVANS KIN MUN YIM DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 08/07/2020
Certification Date: 08/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46-005 KAWA ST
KANEOHE HI
96744-3805
US

IV. Provider business mailing address

46-005 KAWA ST
KANEOHE HI
96744-3805
US

V. Phone/Fax

Practice location:
  • Phone: 808-235-0550
  • Fax: 808-234-1166
Mailing address:
  • Phone: 808-235-0550
  • Fax: 808-234-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDT-2629
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: