LOUIS M KIM A PROFESSIONAL DENTAL CORPORATION NPI 1104336478

NPI Information

NPI: 1104336478
Provider Name: LOUIS M KIM, A PROFESSIONAL DENTAL CORPORATION
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1824 AVONDALE AVE
SACRAMENTO, CA
ZIP 95825
Phone: (916) 900-8521
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LOUIS M KIM, A PROFESSIONAL DENTAL CORPORATION is a dental clinic center in Sacramento, CA. LOUIS M KIM, A PROFESSIONAL DENTAL CORPORATION NPI is 1104336478. The provider is registered as an organization entity type.

The provider's business location address is:

1824 AVONDALE AVE
SACRAMENTO, CA
ZIP 95825-378
Phone: (916) 900-8521
Fax: (916) 900-8526

The provider's authorized official is Louis Kim .
The authorized official title is Owner/dentist and has the following contact phone number (916) 900-8521.

The enumeration date for this NPI number is 10/2/2017 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	53231	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1174711522	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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