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General NPI Number Information
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NPI Number | 1043001613
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Entity Type | Organization
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Legal Business Name | JOANNE J .KIM DDS INC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1220 N PARK AVE
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City | POMONA
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State | CA
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Zip | 91768-3029
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Country | US
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Telephone | 909-397-9791
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Fax | 909-397-9792
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Provider Business Mailing Address
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Address Line | 1220 N PARK AVE
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City | POMONA
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State | CA
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Zip | 91768-3029
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Country | US
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Telephone | 909-397-9791
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Fax | 909-397-9792
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Authorized Official
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Title or Position | OWNER
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Name | MISS JOANNE J KIM
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Credential | DDS
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Telephone | 909-397-9791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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