Provider Demographics
NPI:1427281914
Name:KIM, AH YOUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:AH YOUNG
Middle Name:
Last Name:KIM
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 1:1080 N HILLS BLVD # 150
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-6744
Mailing Address - Country:US
Mailing Address - Phone:775-677-0790
Mailing Address - Fax:
Practice Address - Street 1:1080 N HILLS BLVD # 150
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-6744
Practice Address - Country:US
Practice Address - Phone:775-677-0790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist