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General NPI Number Information
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NPI Number | 1053285106
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Entity Type | Organization
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Legal Business Name | MINJAE KIM DMD, INC.
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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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 | 415-989-8202
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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 | OWNER/DENTIST
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Name | DR. MINJAE KIM
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Credential | DMD
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Telephone | 510-821-5505
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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 |
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License Number State |
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