Individual ProviderRaymond N KimDentistDental ProvidersPractice Address7312 W Cheyenne Ave, Suie 3, Las Vegas, NV 89129-7428(702) 396-9924PECOS EnrollmentBased on the most recent information from CMS, provider Raymond N Kim does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1215940432Provider TypeIndividualFull NameKim, Raymond NCredentialDDSGenderMaleSole ProprietorNoEnumeration Date8/15/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address7312 W Cheyenne Ave, Suie 3, Las Vegas, NV 89129-7428Phone(702) 396-9924Fax(702) 396-3735Mailing LocationMailing Address7312 W Cheyenne Ave, Suie 3, Las Vegas, NV 89129-7428Phone(702) 396-9924Fax(702) 396-3735Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicense3336NevadaCode122300000XDescriptionDentistDental ProvidersLicense43028California