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General NPI Number Information
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NPI Number | 1366592842
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Entity Type | Individual
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Provider Name | JI-HYUN KIM DDS
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 1404 N BEN MADDOX WAY
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City | VISALIA
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State | CA
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Zip | 93292-2246
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Country | US
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Telephone | 559-741-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 4042 W CLINTON ST
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City | VISALIA
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State | CA
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Zip | 93291-8401
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Country | US
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Telephone | 559-363-1409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 54163
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License Number State | CA
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