Provider Demographics
NPI:1386692259
Name:KIM, HYO S I (DDS)
Entity type:Individual
Prefix:DR
First Name:HYO
Middle Name:S
Last Name:KIM
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-1215
Mailing Address - Country:US
Mailing Address - Phone:513-899-3789
Mailing Address - Fax:513-899-2663
Practice Address - Street 1:155 E PIKE ST
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-1215
Practice Address - Country:US
Practice Address - Phone:513-899-3789
Practice Address - Fax:513-899-2663
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300216521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice