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General NPI Number Information
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NPI Number | 1598618050
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Entity Type | Organization
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Legal Business Name | MARY ANN KIM, DDS., PC
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 2101 N DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60647-4528
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Country | US
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Telephone | 773-227-8005
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Fax | 773-227-9115
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Provider Business Mailing Address
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Address Line | 2101 N DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60647-4528
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Country | US
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Telephone | 773-227-8005
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Fax | 773-227-9115
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. MARY ANN KIM
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Credential | DDS
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Telephone | 773-227-8005
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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 |
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License Number State |
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