Provider Demographics
NPI:1285072835
Name:KIM, JI HYUN (DDS)
Entity type:Individual
Prefix:DR
First Name:JI HYUN
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JIHYUN-ELIZABETH
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7 LEXINGTON AVE
Mailing Address - Street 2:APT 6E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5517
Mailing Address - Country:US
Mailing Address - Phone:206-235-1146
Mailing Address - Fax:
Practice Address - Street 1:7 LEXINGTON AVE
Practice Address - Street 2:APT 6E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5517
Practice Address - Country:US
Practice Address - Phone:206-235-1146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA624051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics