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General NPI Number Information
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NPI Number | 1396980611
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Entity Type | Individual
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Provider Name | DO YOON KIM MD, DDS
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Gender | Male
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Dates
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Enumeration Date | 12/16/2008
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Last Update Date | 08/11/2024
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Provider Practice Location Address
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Address Line | 901 MOUNTAIN AVE # SC13
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-3414
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Country | US
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Telephone | 973-315-7830
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 LINWOOD AVE APT 12T
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City | FORT LEE
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State | NJ
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Zip | 07024-3157
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Country | US
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Telephone | 917-673-9491
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 061438
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 10326
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 307534
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI02391200
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License Number State | NJ
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