| Organization Name: | DONG JIN KIM, DDS, INC |
| NPI Number: | 1346658622 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA TAK KIM (OWNER) |
| Mailing Address: | 69420 Ramon Rd Cathedral City |
| State: | CA US |
| Postal Code: | 922343349 |
| Phone Number: | 7602021171 |
| Fax Number: | 7602021170 |
| NPI Enumeration Date: | 07/30/2014 |
| NPI Last Update Date: | 07/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 45327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |