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:
Health care specialties
Specialty | Code | License # | 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 12 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 | 1174818496 | NPPES |
New York | Other | P77908 | NY STATE TEACHING PERMIT NO |
New York | MEDICAID | 034481918 | NY STATE TEACHING PERMIT NO |
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