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NPI Code Detail

MEDICARE: DR. KYONG HI KIM DDS

MEDICARE:  DR. KYONG HI KIM  DDS
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
11223G0001XGeneral Practice Dentistry4145SC

General Provider Information

NPI Number : 1184608226
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYONG HI KIM DDS
Provider Business Mailing Address
First Line : 6941 N TRENHOLM RD STE E
Second Line :
City : COLUMBIA
State : SC
Zip : 29206-1715
Country : US
Telephone Number : 803-743-9894
Fax Number : 803-743-9896
Provider Business Practice Location Address
First Line : 6941 N TRENHOLM RD STE E
Second Line :
City : COLUMBIA
State : SC
Zip : 29206-1715
Country : US
Telephone Number : 803-743-9894
Fax Number : 803-743-9896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 05/07/2021

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Directions to “ DR. KYONG HI KIM DDS” Practice Location

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