Provider Demographics
NPI:1396076196
Name:KIM-YU, HE-KYUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:HE-KYUNG
Middle Name:
Last Name:KIM-YU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 WELSH RD
Mailing Address - Street 2:SUITE: G
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2054
Mailing Address - Country:US
Mailing Address - Phone:215-362-3000
Mailing Address - Fax:267-263-1499
Practice Address - Street 1:1222 WELSH RD
Practice Address - Street 2:SUITE: G
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2054
Practice Address - Country:US
Practice Address - Phone:215-362-3000
Practice Address - Fax:267-263-1499
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-026455-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice