Healthcare Provider Details

I. General information

NPI: 1013596451
Provider Name (Legal Business Name): DAVID KIM DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CHERRY HILL RD
PARSIPPANY NJ
07054-1111
US

IV. Provider business mailing address

299 CHERRY HILL RD STE 204
PARSIPPANY NJ
07054-1124
US

V. Phone/Fax

Practice location:
  • Phone: 216-339-2384
  • Fax:
Mailing address:
  • Phone: 216-339-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS043049
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: