MEDICARE: EUGENE JUNG 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	9251	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851389225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE JUNG KIM DDS

Provider Business Mailing Address
First Line	:	8575 E PRINCESS DR
Second Line	:	SUITE 217
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-5483
Country	:	US
Telephone Number	:	480-342-8200
Fax Number	:	480-342-8008

Provider Business Practice Location Address
First Line	:	8575 E PRINCESS DR
Second Line	:	SUITE 217
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-5483
Country	:	US
Telephone Number	:	480-342-8200
Fax Number	:	480-342-8008

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	03/07/2023

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Directions to “ EUGENE JUNG KIM DDS” Practice Location

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