Individual
JIWON LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MPH
Contact information
Practice address
1222 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3410
(434) 924-1774
(434) 982-6417
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0411000075
VA
1223G0001X
General Practice Dentistry
11867
NC
125Q00000X
Oral Medicine Dentistry
0411000075
VA
Other
Enumeration date
06/17/2020
Last updated
04/09/2025
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