Kim, Michelle

Kim, Michelle is an sole proprietor health care provider with primary practice located at 901 W 38Th St Suite 410, Austin TX 78705-1163. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Kim, Michelle can be contacted via phone (512) 992-1378.

Contact Information

Primary practice address
901 W 38Th St Suite 410 Austin TX 78705-1163
Phone: (512) 992-1378
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 30213 Texas

Profile Details

NPI number 1972925105
LBN Legal business name Kim, Michelle
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 7th, 2014
Last updated Mar 27th, 2017 - about 9 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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Identifiers

StateTypeNumberIssuer
All States NPI 1972925105 NPPES
Texas MEDICAID 340556510
Texas MEDICAID 340556511

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