Provider Demographics
NPI:1255856191
Name:MUNG, KYIM (DDS, MA)
Entity type:Individual
Prefix:DR
First Name:KYIM
Middle Name:
Last Name:MUNG
Suffix:
Gender:F
Credentials:DDS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 GREENFIELD AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3673
Mailing Address - Country:US
Mailing Address - Phone:951-531-3255
Mailing Address - Fax:
Practice Address - Street 1:329 W 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4533
Practice Address - Country:US
Practice Address - Phone:559-587-2505
Practice Address - Fax:559-587-2510
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1017781223G0001X
CA101778390200000X, 1223P0221X
TX376411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program