Kim, Andrew D
Kim, Andrew D is an sole proprietor health care provider with primary practice located at 573 Martin Luther King Jr Blvd , Newark NJ 07102-1215. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Kim, Andrew D can be contacted via phone (973) 621-6678.Contact Information
Primary practice address
573 Martin Luther King Jr Blvd
Newark NJ 07102-1215
Phone: (973) 621-6678
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 20618 | New Jersey |
Profile Details
| NPI number | 1578517801 |
|---|---|
| LBN Legal business name | Kim, Andrew D |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 20th, 2006 |
| Last updated | Sep 23rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578517801 | NPPES |
| New Jersey | MEDICAID | 8049301 |
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