Kim, Diana

Kim, Diana is an sole proprietor health care provider with primary practice located at 3130 E Main St Ste 200 , Mohegan Lake NY 10547-1517. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Kim, Diana can be contacted via phone (845) 284-6296.

Contact Information

Primary practice address
3130 E Main St Ste 200 Mohegan Lake NY 10547-1517
Phone: (845) 284-6296
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X 063195 New York

Profile Details

NPI number 1578295556
LBN Legal business name Kim, Diana
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2022
Last updated Aug 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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