# JD KIM MD, DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598044356
- **Authorized official:** DR. JEONG DOO KIM MD, DDS (PRESIDENT)
- **Authorized official phone:** (310) 713-5159

## Contact information

- **Practice address:** 4000 TYLER ST STE A, RIVERSIDE, CA 92503-3458
- **Practice address phone:** (951) 687-4460
- **Practice address fax:** (951) 687-7448
- **Mailing address:** 20760 PASEO DE LA RAMBLA, YORBA LINDA, CA 92887
- **Mailing address phone:** (310) 713-5159
- **Mailing address fax:** (951) 687-7448

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 50622 | CA | Yes |

## Other

- **Enumeration date:** 08/11/2011
- **Last updated:** 08/11/2011