Provider Demographics
NPI:1427723568
Name:KIM, CHRISTOPHER YOUNGBIN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:YOUNGBIN
Last Name:KIM
Suffix:
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 1:9606 DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2824
Mailing Address - Country:US
Mailing Address - Phone:417-576-0362
Mailing Address - Fax:
Practice Address - Street 1:16103 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1516
Practice Address - Country:US
Practice Address - Phone:913-829-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS619101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice