Active NPI
Pearlbrite Dental
- Prosthodontics
- Centreville, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 0401008847
- Legal business name
- PEARLBRITE DENTAL
- Practice address
- 14631 Lee Hwy Ste 116
Centreville, VA 20121-5825 - Phone
- (703) 988-9006
- NPI assigned
- Mar 2, 2016
- Last updated
- Mar 2, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joongseo Kim
- Title
- Owner
- Phone
- (703) 988-9006
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 0401413569 | VA | |
| Prosthodontics | 1223P0700X | 12296 | MD | |
| Prosthodontics | 1223P0700X | 0401008847 | VA | Primary |
Addresses
Primary practice location
14631 Lee Hwy Ste 116
Centreville, VA 20121-5825
Mailing address
301 Maple Ave W Ste 610
Vienna, VA 22180-4300
Phone (703) 281-7011
National Provider Directory
National Provider Directory- Tax ID family
- Franconia Dental Care
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
301 Maple Ave W
Ste 610
Vienna, VA 22180
Phone (703) 281-7011
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Vienna, VA
- NPI 1437212826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1456876800000",
"number": "1033579123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 MAPLE AVE W STE 610",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804300",
"telephone_number": "703-281-7011",
"fax_number": "703-281-7030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14631 LEE HWY STE 116",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201215825",
"telephone_number": "703-988-9006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEARLBRITE DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2016-03-02",
"last_updated": "2016-03-02",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "JOONGSEO",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-988-9006",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401413569",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MD",
"license": "12296",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "VA",
"license": "0401008847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.