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General NPI Number Information
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NPI Number | 1871893008
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Entity Type | Individual
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Provider Name | HANNA S KIM DDS
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Gender | Female
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 20214 BALINGER WAY NE
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City | SHORELINE
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State | WA
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Zip | 98155
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Country | US
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Telephone | 206-605-5321
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Fax |
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Provider Business Mailing Address
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Address Line | 218 MAIN ST STE 800
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City | KIRKLAND
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State | WA
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Zip | 98033-6108
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Country | US
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Telephone | 206-605-5321
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | GA60178267
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License Number State | WA
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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 | DE 60147287
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License Number State | WA
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