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General NPI Number Information
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NPI Number | 1508343120
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Entity Type | Individual
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Provider Name | JI HYUN LIM
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Gender | Male
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 77 QUAKER RIDGE RD STE 206
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-2821
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Country | US
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Telephone | 914-301-6305
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Fax |
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Provider Business Mailing Address
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Address Line | 425 WASHINGTON BLVD APT 2411
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City | JERSEY CITY
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State | NJ
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Zip | 07310-2021
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Country | US
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Telephone | 971-873-3239
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 061535
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02831000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 04436
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License Number State | NH
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