NPI 1316305352 · live from the CMS NPI Registry
Sung Ho Kim, D.D.S.
Dentist in Chesterfield, MO. National Provider Identifier 1316305352, active.
NPI record
| NPI | 1316305352 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 1001 Chesterfield Pkwy E Ste 202, Chesterfield, MO 63017 |
| Practice phone | 636-532-2228 |
| Mailing address | 7125 N Durango Dr, Las Vegas, NV 89149 |
| Enumerated | February 5, 2016 |
| Last updated | October 21, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | S3-335C (NV) |
| Dentist primary | 122300000X | 2015040188 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.