| Youngsam Kim Dental Corporation | |
|
4330 Barranca Pkwy Ste 140 Irvine CA 92604-1703 | |
| (949) 523-2875 | |
| Not Available |
| Full Name | Youngsam Kim Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 4330 Barranca Pkwy Ste 140, Irvine, California |
| Authorized Official Name and Position | Janice Park (ADMIN) |
| Authorized Official Contact | 7143374410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Youngsam Kim Dental Corporation 4330 Barranca Pkwy Ste 140 Irvine CA 92604-1703 Ph: () - | Youngsam Kim Dental Corporation 4330 Barranca Pkwy Ste 140 Irvine CA 92604-1703 Ph: (949) 523-2875 |
| NPI Number | 1023525201 |
|---|---|
| Provider Enumeration Date | 01/09/2018 |
| Last Update Date | 04/22/2019 |
| Medicare PECOS PAC ID | 0840550430 |
|---|---|
| Medicare Enrollment ID | O20180130000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023525201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Youngsam Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1942699160 PECOS PAC ID: 2668732256 Enrollment ID: I20180131001564 |
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