Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RODERICK YOUNGDO KIM, DDS, MD
Active Sole ProprietorRODERICK YOUNGDO KIM, DDS, MD is a Oral & Maxillofacial Surgery (Physician) healthcare provider located in FORT WORTH, Texas. NPI 1689954562 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery (Physician) · FORT WORTH, TX
Registration Details
- NPI Number
- 1689954562
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 23, 2011 (14.956342531743 yrs)
- Last Updated
- Jun 26, 2024
- Licenses
-
32838 (TX)32838 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1500 S MAIN ST DEPT OFFORT WORTH, TX, 761044917Browse TX providers · Browse ZIP 76104
- Phone
- 8177026936
- Primary Specialty
-
Oral & Maxillofacial Surgery (Physician)
204E00000X
- Additional Specialty
- Oral & Maxillofacial Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.