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General NPI Number Information
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NPI Number | 1306646260
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Entity Type | Organization
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Legal Business Name | C DENTAL PLLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 242 W 20TH ST
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City | NEW YORK
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State | NY
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Zip | 10011-3535
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Country | US
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Telephone | 646-450-0722
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Fax |
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Provider Business Mailing Address
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Address Line | 103 MONTGOMERY ST APT 3
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City | JERSEY CITY
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State | NJ
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Zip | 07302-3703
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Country | US
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Telephone | 646-450-0722
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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 | MS. CAROLINE SOYOUNG KIM
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Credential | DDS
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Telephone | 916-730-7815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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