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General NPI Number Information
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NPI Number | 1902586266
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Entity Type | Individual
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Provider Name | JIHANG KIM
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Gender | Female
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 51 HAMILTON ST
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City | WORCESTER
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State | MA
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Zip | 01604-2203
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Country | US
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Telephone | 774-375-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 125 GUEST ST APT 603
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City | BOSTON
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State | MA
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Zip | 02135-2084
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Country | US
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Telephone | 917-224-5373
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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 | DN10001452
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License Number State | MA
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