Provider Demographics
NPI:1932309499
Name:KIM, HENRY HYUCK KUN (DDS)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:HYUCK KUN
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 1:5301 MADISON AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-3146
Mailing Address - Country:US
Mailing Address - Phone:916-967-9953
Mailing Address - Fax:
Practice Address - Street 1:5301 MADISON AVE STE 402
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3146
Practice Address - Country:US
Practice Address - Phone:916-967-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice