Healthcare Provider Details

I. General information

NPI: 1730276726
Provider Name (Legal Business Name): KIM CHARLES SYKORA D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 E GAY ST STE 3
WEST CHESTER PA
19380-4567
US

IV. Provider business mailing address

11 SUNNYSIDE RD
THORNTON PA
19373-1018
US

V. Phone/Fax

Practice location:
  • Phone: 610-696-9119
  • Fax: 610-696-9170
Mailing address:
  • Phone: 484-899-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS035550
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: