Provider Demographics
NPI:1285946749
Name:KIM, HYUN MIN (DDS)
Entity type:Individual
Prefix:DR
First Name:HYUN
Middle Name:MIN
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CALVIN
Other - Middle Name:MIN
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1196 E DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-8305
Mailing Address - Country:US
Mailing Address - Phone:847-716-3100
Mailing Address - Fax:
Practice Address - Street 1:1198 E DUNDEE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-8305
Practice Address - Country:US
Practice Address - Phone:773-398-5822
Practice Address - Fax:630-428-2182
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028417122300000X
TX32625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist