Yeo Jin Kim
Dentist, General Practice in New York, NY. Individual provider (NPI-1).
NPI number1801242425
StatusActive
Last updated in NPPESMar 2, 2020
Details
- NPI
- 1801242425
- Entity type
- Individual (NPI-1)
- Name
- Yeo Jin Kim
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 12, 2016
- Certification date
- Mar 2, 2020
- Last updated
- Mar 2, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 059144 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
11 Stuyvesant Oval Apt 1hNew York, NY 10009-2047
Phone 814-308-3062
Mailing address
11 Stuyvesant Oval Apt 1hNew York, NY 10009-2047
Phone 814-308-3062
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