Fred Young Kim, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401416364 Issued in VA

Practice address

1705 Amherst St Ste 201
Winchester, VA 22601-3346

Phone

(540) 667-5437

NPI assigned

Jul 15, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gaurav Agarwal DDS, MSD, PLLC

  • Dental Clinic/Center
  • Winchester, VA
  • NPI 1760635585
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1124435771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 AMHERST ST STE 201",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013346",
            "telephone_number": "540-667-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 AMHERST ST STE 201",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013346",
            "telephone_number": "540-667-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "FRED",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "33184",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401416364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie S Kidd, MD
• Thomas Ali Kidd Jr., PAC
• Jason Kidwell
• Katherine F Killmer
• Byung Yoon Kim, DDS
• Kimble Chiropractic, LLC
• Kati Kimble
• Skylar Trevor Kimble, LPTA
• Jon Travis King
• Julie S King, MD

• Pediatric Dentistry in Winchester, VA
• Providers in Winchester, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.