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General NPI Number Information
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NPI Number | 1497318885
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Entity Type | Organization
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Legal Business Name | YOON S. KIM DDS INC.
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Dates
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Enumeration Date | 04/21/2019
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 1517 W 6TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90017-1708
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Country | US
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Telephone | 213-483-0772
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Fax | 213-483-1574
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Provider Business Mailing Address
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Address Line | 1517 W 6TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90017-1708
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Country | US
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Telephone | 213-483-0772
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Fax | 213-483-1574
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Authorized Official
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Title or Position | CEO/DENTIST
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Name | DR. YOON SUNG KIM
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Credential | DDS
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Telephone | 213-483-0772
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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 |
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License Number State |
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