Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pyo Jae Kim

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1659991107

Pyo Jae Kim is a Student in an Organized Health Care Education/Training Program in Troy, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2020
Specialties on file
2

Practice location Address checks out

805 Sandalwood Dr
Troy, MI 48085-1643
Phone: (213) 400-2614
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2901600680 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1659991107
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 24, 2020
Last updated in NPPESJanuary 19, 2021
Certification dateJanuary 19, 2021
Mailing address805 Sandalwood Dr, Troy, MI 48085-1643

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