Provider Demographics
NPI:1396637831
Name:MIN, KYUNG UK (DMD)
Entity type:Individual
Prefix:DR
First Name:KYUNG UK
Middle Name:
Last Name:MIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 MARKET ST # 1321
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-2903
Mailing Address - Country:US
Mailing Address - Phone:954-999-8933
Mailing Address - Fax:
Practice Address - Street 1:1500 JOHN F KENNEDY BLVD STE 1906
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1714
Practice Address - Country:US
Practice Address - Phone:215-709-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS045304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist