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General NPI Number Information
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NPI Number | 1770324972
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Entity Type | Individual
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Provider Name | ANNA STEPHANIE KIM DMD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3640 CROCKER DR STE 130
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City | SACRAMENTO
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State | CA
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Zip | 95818-3970
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Country | US
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Telephone | 916-550-9429
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Fax |
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Provider Business Mailing Address
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Address Line | 21525 ADDINGTON CT
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City | CUPERTINO
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State | CA
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Zip | 95014-4847
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Country | US
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Telephone | 408-691-9131
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS111431
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License Number State | CA
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