Provider Demographics
NPI:1891909842
Name:KIM, DANIEL MUHUN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MUHUN
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 E CARONDELET DR STE 355
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-3523
Mailing Address - Country:US
Mailing Address - Phone:520-733-9225
Mailing Address - Fax:
Practice Address - Street 1:6565 E CARONDELET DR STE 355
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3523
Practice Address - Country:US
Practice Address - Phone:520-733-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ62401223G0001X
MO20210303721223P0300X
AZD062401223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice