| Bryan Kim Dds Inc | |
|
26440 La Alameda Ste 320 Mission Viejo CA 92691-6304 | |
| (949) 445-1234 | |
| (949) 445-1337 |
| Full Name | Bryan Kim Dds Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 26440 La Alameda Ste 320, Mission Viejo, California |
| Authorized Official Name and Position | Bryan Kim (OWNER) |
| Authorized Official Contact | 9098393685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan Kim Dds Inc 26440 La Alameda Ste 320 Mission Viejo CA 92691-6304 Ph: (949) 445-1234 | Bryan Kim Dds Inc 26440 La Alameda Ste 320 Mission Viejo CA 92691-6304 Ph: (949) 445-1234 |
| NPI Number | 1689142648 |
|---|---|
| Provider Enumeration Date | 11/08/2018 |
| Last Update Date | 10/20/2023 |
| Medicare PECOS PAC ID | 3971843632 |
|---|---|
| Medicare Enrollment ID | O20190318000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689142648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Bryan M Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1962893255 PECOS PAC ID: 2668723289 Enrollment ID: I20180920002706 |
| Provider Name | Soo Jin Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518451103 PECOS PAC ID: 8820447568 Enrollment ID: I20231207000288 |
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