Jae Shim, DDS

NPI 1669504221 · on the registry since 2007 · sole proprietor

Practice

Address: 1800 Grand Ave
Waukegan, IL 60085
Phone: (847) 336-4180
Fax: (847) 336-4190
Organisation at this address: Health Reach, Inc
Pads Lake County Inc.
Grand Dental Care, Ltd
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois