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General NPI Number Information
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NPI Number | 1851018121
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Entity Type | Organization
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Legal Business Name | JOHNNY KH KIM DDS, INC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 6905 1/2 ATLANTIC AVE
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City | BELL
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State | CA
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Zip | 90201-3661
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Country | US
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Telephone | 323-863-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 936 CRENSHAW BLVD # 100
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City | LOS ANGELES
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State | CA
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Zip | 90019-1957
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Country | US
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Telephone | 323-617-4180
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHNNY KIM
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Credential | DDS
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Telephone | 323-863-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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