Provider Demographics
NPI:1497563555
Name:RAINBOW KIDS DENTAL, INC.
Entity type:Organization
Organization Name:RAINBOW KIDS DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNGKI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-452-0100
Mailing Address - Street 1:3900 PARK AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3063
Mailing Address - Country:US
Mailing Address - Phone:732-452-0100
Mailing Address - Fax:732-452-0178
Practice Address - Street 1:3900 PARK AVE STE 105
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3063
Practice Address - Country:US
Practice Address - Phone:732-452-0100
Practice Address - Fax:732-452-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty