Provider Demographics
NPI:1528751401
Name:KIM, HELEN HA HYUN (DDS)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:HA HYUN
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25701 HOLIDAY CIR APT E
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1249
Mailing Address - Country:US
Mailing Address - Phone:516-784-7152
Mailing Address - Fax:
Practice Address - Street 1:27421 TOURNEY RD STE 270
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5646
Practice Address - Country:US
Practice Address - Phone:661-799-7912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1108411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice