MEDICARE: DR. GILBERT Y 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
1	122300000X	Dentist	037981-1	NY

General Provider Information

NPI Number	:	1700925203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILBERT Y KIM DDS

Provider Business Mailing Address
First Line	:	22902 HORACE HARDING EXPY # 2
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2434
Country	:	US
Telephone Number	:	347-804-8465
Fax Number	:

Provider Business Practice Location Address
First Line	:	13336 41ST RD # 2Q
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-3666
Country	:	US
Telephone Number	:	347-804-8465
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	05/13/2022

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