Kim, Jung H

Kim, Jung H is an sole proprietor health care provider with primary practice located at 309A Broad Ave , Palisades Park NJ 07650-1620. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Kim, Jung H can be contacted via phone (201) 242-9300.

Contact Information

Primary practice address
309A Broad Ave Palisades Park NJ 07650-1620
Phone: (201) 242-9300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 056054 New York
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 22DI02504500 New Jersey

Profile Details

NPI number 1174818496
LBN Legal business name Kim, Jung H
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2011
Last updated Nov 15th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174818496 NPPES
New York Other P77908 NY STATE TEACHING PERMIT NO
New York MEDICAID 034481918 NY STATE TEACHING PERMIT NO

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