Provider Demographics
NPI:1194999219
Name:DR HWAYOUN KIM DDS INC
Entity type:Organization
Organization Name:DR HWAYOUN KIM DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HWA
Authorized Official - Middle Name:YOUN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PHD
Authorized Official - Phone:916-974-1819
Mailing Address - Street 1:3307 ALTA ARDEN EXPY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2102
Mailing Address - Country:US
Mailing Address - Phone:916-974-1819
Mailing Address - Fax:916-974-7568
Practice Address - Street 1:3307 ALTA ARDEN EXPY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2102
Practice Address - Country:US
Practice Address - Phone:916-974-1819
Practice Address - Fax:916-974-7568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45891261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental