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General NPI Number Information
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NPI Number | 1710807847
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Entity Type | Organization
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Legal Business Name | JI MIN MOON DDS INC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 6000 CAMINO REAL
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City | JURUPA VALLEY
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State | CA
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Zip | 92509-5310
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Country | US
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Telephone | 951-360-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 CAMINO REAL
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City | JURUPA VALLEY
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State | CA
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Zip | 92509-5310
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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 | PRESIDENT
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Name | JI MIN MOON
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Credential | DDS
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Telephone | 951-215-5918
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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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