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Ji Yeon Kim

Dentist, General Practice in Dallas, TX. Individual provider (NPI-1).

NPI number1316632011
StatusActive
Last updated in NPPESJul 10, 2025

Details

NPI
1316632011
Entity type
Individual (NPI-1)
Name
Ji Yeon Kim
Sex
Female
Sole proprietor
No
Enumeration date
Apr 7, 2023
Certification date
Jul 9, 2025
Last updated
Jul 10, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice41513TXYes

Practice location

3302 Gaston Ave
Dallas, TX 75246-2013

Phone 214-828-8215

Mailing address

3302 Gaston Ave
Dallas, TX 75246-2013

Phone 214-828-8215

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