MEDICARE: SUE YOUNG KIM DDS A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	50767	CA

General Provider Information

NPI Number	:	1063863017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUE YOUNG KIM DDS A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	6053 E JACK PINE LN
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92869-1542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1319 N MAIN ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-2318
Country	:	US
Telephone Number	:	714-972-2782
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUE YOUNG KIM
Credential	:	DDS
Telephone Number	:	213-700-9627

Provider Enumeration Date	:	06/30/2016
Last Update Date	:	06/30/2016

Similar Medicare Providers

1356625537 — SHAHIN MAHALLATI DDS INC
Practice Location Address:

1319 N MAIN ST
SANTA ANA, CA
92701-2318

Practice Phone: 714-972-2782
Practice Fax:

1467233395 — RASHI VOHRA DENTAL CARE
Practice Location Address:

1319 N MAIN ST
SANTA ANA, CA
92701-2318

Practice Phone: 714-972-2782
Practice Fax:

1609391366 — EDMAR ALBERTO DUENAS PTA
Practice Location Address:

2318 FRANZEN AVE APT A
SANTA ANA, CA
92705-1756

Practice Phone: 714-317-0893
Practice Fax:

1811450042 — MS. GIOVANNA MARIE PIAZZA M.DIV,. BCC
Practice Location Address:

2318 BONNIE BRAE
SANTA ANA, CA
92706-1603

Practice Phone: 714-271-3712
Practice Fax:

1518023142 — LUXOTTICA RETAIL NORTH AMERICA INC
Practice Location Address:

302 COLORADO AVE
SANTA MONICA, CA
90401-2318

Practice Phone: 310-576-2918
Practice Fax:

1740552447 — ANIKA DEWAN O.D. INC.
Practice Location Address:

302 COLORADO AVE
SANTA MONICA, CA
90401-2318

Practice Phone: 310-393-5503
Practice Fax:

Directions to “SUE YOUNG KIM DDS A PROFESSIONAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.