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General NPI Number Information
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NPI Number | 1215051370
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Entity Type | Organization
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Legal Business Name | KIM AND YI DENTAL CORPORATION
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 565 E EL CAMINO REAL
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City | SUNNYVALE
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State | CA
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Zip | 94087-1942
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Country | US
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Telephone | 408-730-8000
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Fax | 408-730-8002
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Provider Business Mailing Address
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Address Line | 565 E EL CAMINO REAL
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City | SUNNYVALE
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State | CA
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Zip | 94087-1942
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Country | US
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Telephone | 408-730-8000
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Fax | 408-730-8002
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER KIM
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Credential | DDS MS
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Telephone | 408-730-8000
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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 | 41268
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License Number State | CA
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