| Jin Y. Kim Dds, Inc. | |
|
9681 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1548 | |
| (713) 539-8275 | |
| (714) 539-8284 |
| Full Name | Jin Y. Kim Dds, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 9681 Garden Grove Blvd Ste 104, Garden Grove, California |
| Authorized Official Name and Position | Jin Young Kim (PRESIDENT) |
| Authorized Official Contact | 3234456144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jin Y. Kim Dds, Inc. 9681 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1548 Ph: (714) 539-8275 | Jin Y. Kim Dds, Inc. 9681 Garden Grove Blvd Ste 104 Garden Grove CA 92844-1548 Ph: (713) 539-8275 |
| NPI Number | 1063687937 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 03/27/2020 |
| Medicare PECOS PAC ID | 5193041564 |
|---|---|
| Medicare Enrollment ID | O20150302000996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063687937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54575 (California) | Secondary |
| 1223P0700X | Dentist - Prosthodontics | 54575 (California) | Primary |
| Provider Name | Jin Young Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922296623 PECOS PAC ID: 6002132479 Enrollment ID: I20150302001262 |
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