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General NPI Number Information
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NPI Number | 1033721857
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Entity Type | Individual
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Provider Name | MINJAE KIM DMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 133 KEARNY ST STE 301
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4811
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Country | US
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Telephone | 415-989-3648
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Fax |
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Provider Business Mailing Address
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Address Line | 228 ENCOUNTER BAY
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City | ALAMEDA
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State | CA
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Zip | 94502-7909
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Country | US
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Telephone | 510-821-5505
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 105331
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License Number State | CA
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