Healthcare Provider Details

I. General information

NPI: 1184065997
Provider Name (Legal Business Name): MINJOO KIM SANKER DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2074 S MAIN ST
ANN ARBOR MI
48103-5827
US

IV. Provider business mailing address

2000 GREEN RD # 101
ANN ARBOR MI
48105-1598
US

V. Phone/Fax

Practice location:
  • Phone: 734-663-2490
  • Fax:
Mailing address:
  • Phone: 734-375-6882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901020946
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2901020946
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: