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General NPI Number Information
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NPI Number | 1669775219
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Entity Type | Organization
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Legal Business Name | SIMPLY ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 90 BRYANT AVE UNIT TC EMBASSY BUILDING
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1952
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Country | US
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Telephone | 914-946-6910
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Fax |
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Provider Business Mailing Address
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Address Line | 90 BRYANT AVE UNIT TC EMBASSY BUILDING
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1952
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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
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Name | DR. JEFFREY J. KIM
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Credential | DDS
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Telephone | 914-946-6910
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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 | 044694-1
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License Number State | NY
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