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General NPI Number Information
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NPI Number | 1326244591
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Entity Type | Organization
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Legal Business Name | JAMES MYUNG JU KIM DDS INC
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 7128 PACIFIC BLVD #B
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255
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Country | US
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Telephone | 323-588-0400
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Fax | 323-588-1854
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Provider Business Mailing Address
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Address Line | 7128 PACIFIC BLVD #B
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255
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Country | US
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Telephone | 323-588-0400
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Fax | 323-588-1854
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES MYUNG JU KIM
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Credential | D.D.S
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Telephone | 323-588-0400
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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 | 49122
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49910
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License Number State | CA
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