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General NPI Number Information
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NPI Number | 1841475761
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Entity Type | Individual
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Provider Name | SAVANNAH J. KIM D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 531 ELM ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4549
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Country | US
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Telephone | 475-313-0176
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Fax |
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Provider Business Mailing Address
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Address Line | 10810 N TATUM BLVD STE 102-766
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City | PHOENIX
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State | AZ
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Zip | 85028-6055
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Country | US
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Telephone | 650-293-7090
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 063803-01
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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 | 56483
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 14543
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License Number State | CT
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