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General NPI Number Information
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NPI Number | 1427941400
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Entity Type | Organization
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Legal Business Name | MIN K KIM LLC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1350 S DECATUR BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-8510
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Country | US
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Telephone | 702-760-6080
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Fax |
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Provider Business Mailing Address
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Address Line | 372 VALLEGGIA DR
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City | LAS VEGAS
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State | NV
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Zip | 89138-6106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. MIN KYU KIM
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Credential | DMD, MS
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Telephone | 267-240-5462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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