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General NPI Number Information
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NPI Number | 1003293077
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Entity Type | Individual
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Provider Name | CHRIS S KIM DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 11/02/2025
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Provider Practice Location Address
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Address Line | 1221 SHERWOOD PARK DR NE STE C
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City | GAINESVILLE
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State | GA
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Zip | 30501-3404
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Country | US
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Telephone | 678-336-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 SHERWOOD PARK DR NE STE C
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City | GAINESVILLE
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State | GA
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Zip | 30501-3404
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Country | US
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Telephone | 858-740-0706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN015106
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 7115
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D.007382-C
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 11132
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 38247
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License Number State | TX
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