Provider Demographics
NPI:1285157487
Name:KIM, ROSY MINHYE (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSY
Middle Name:MINHYE
Last Name:KIM
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 ROUTE 46 # 1019
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3401
Mailing Address - Country:US
Mailing Address - Phone:909-296-2338
Mailing Address - Fax:
Practice Address - Street 1:144 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-1604
Practice Address - Country:US
Practice Address - Phone:475-422-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043043122300000X
CA101567122300000X
CT133171223G0001X
CAGA20111223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice