Provider Demographics
NPI:1962086728
Name:KIM LEMIRE, DMD INC.
Entity type:Organization
Organization Name:KIM LEMIRE, DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:310-530-5252
Mailing Address - Street 1:1537 LOMITA BLVD
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2024
Mailing Address - Country:US
Mailing Address - Phone:310-530-5252
Mailing Address - Fax:310-530-6922
Practice Address - Street 1:1537 LOMITA BLVD
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2024
Practice Address - Country:US
Practice Address - Phone:310-530-5252
Practice Address - Fax:310-530-6922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61461OtherDENTIST