Individual
DR. SCARLET KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
24481 ALICIA PKWY # 3, MISSION VIEJO, CA 92691-4534
(949) 586-9800
Mailing address
20028 EMERALD MEADOW DR, WALNUT, CA 91789-3506
(909) 631-6653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
00000000
WA
1223G0001X
General Practice Dentistry
D10635
OR
1223P0221X
Pediatric Dentistry
Primary
104759
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WA
Enumeration date
07/15/2016
Last updated
11/24/2020
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