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General NPI Number Information
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NPI Number | 1952166779
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Entity Type | Organization
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Legal Business Name | J LIM DENTAL PLLC
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 36 E 36TH ST STE 1K
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City | NEW YORK
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State | NY
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Zip | 10016-3441
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Country | US
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Telephone | 212-532-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 330 W 58TH ST APT 7M
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City | NEW YORK
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State | NY
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Zip | 10019-1815
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Country | US
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Telephone | 781-201-0312
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Fax |
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Authorized Official
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Title or Position | EMPLOYER
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Name | DR. JISU LIM
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Credential | DDS
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Telephone | 781-201-0312
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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 |
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License Number State |
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