Provider Demographics
NPI:1063547933
Name:LIM, KATHLEEN SUN (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:SUN
Last Name:LIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1715 CARLSON LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4712
Mailing Address - Country:US
Mailing Address - Phone:714-323-4545
Mailing Address - Fax:
Practice Address - Street 1:18102 IRVINE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3423
Practice Address - Country:US
Practice Address - Phone:714-838-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA486371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry