| Organization Name: | KIM AND GANDHI KIM DENTAL CORPORATION |
| NPI Number: | 1083030092 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIN Y. KIM (ORTHODONTIST) |
| Mailing Address: | 5881 Pine Ave, Suite B Chino Hills |
| State: | CA US |
| Postal Code: | 91709 |
| Phone Number: | 4156082837 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2014 |
| NPI Last Update Date: | 03/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 56935 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |