Daeun Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401419094 Issued in VA

Practice address

500 Grove St Ste 303
Herndon, VA 20170-4793

Phone

(703) 793-1771

NPI assigned

Sep 13, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1184450272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13519 MIST FLOWER DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201203025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GROVE ST STE 303",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704793",
            "telephone_number": "703-793-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAEUN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurusher Kaur Khalsa, M.ED., LPC
• Gurutrang Singh Khalsa, D.C.
• Sajjad A Khan, PHD, LCSW
• Isha Khosa, O.D.
• Alice Kim, M.S.W., L.C.S.W.
• Jung Kwan Kim, DC
• Rachel Kim, OD
• Robert Brent Kimble II, D.C.
• Mary Kimmel
• Kind-Care

• Dentist in Herndon, VA
• Providers in Herndon, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.