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General NPI Number Information
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NPI Number | 1952503799
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Entity Type | Individual
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Provider Name | MOONSUN KIM DDS
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 77 QUAKER RIDGE RD STE 210
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-2821
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Country | US
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Telephone | 914-632-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 BROADWAY APT 4C
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City | NEW YORK
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State | NY
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Zip | 10023-5040
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Country | US
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Telephone | 917-327-3863
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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 | 049857
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0498371
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License Number State | NY
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