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General NPI Number Information
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NPI Number | 1972703072
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Entity Type | Individual
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Provider Name | SUNG HO KIM D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 663 N WESTWOOD ST B
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City | PORTERVILLE
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State | CA
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Zip | 93257-6930
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Country | US
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Telephone | 559-781-3641
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Fax | 559-781-3690
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Provider Business Mailing Address
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Address Line | 3235 W STEWART AVE
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City | VISALIA
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State | CA
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Zip | 93291-3267
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Country | US
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Telephone | 559-799-5580
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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 | 55848
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License Number State | CA
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