Individual
DR. DANIEL YEIL KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5201 WASHINGTON AVE STE A, RACINE, WI 53406-4242
(512) 297-6158
Mailing address
5201 WASHINGTON AVE. SUITE A, RACINE, WI 53406-4242
(512) 297-6158
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019030664
IL
1223G0001X
General Practice Dentistry
Primary
1001602-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019030664
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
—
100160215
WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
01
—
1962883926
OFFICE NPI
WI
01
—
319019971
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
12/03/2016
Last updated
03/07/2023
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