Kyu Won Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401413863 Issued in VA

Practice address

4480 King St
Alexandria, VA 22302-1300

Phone

(571) 429-2373

NPI assigned

Jul 3, 2013

Sex

Male

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Alexandria, VA
  • NPI 1164620027
  NPD (past)
• Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Annandale, VA
  • NPI 1841744265
  NPD (past)

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1346680428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEMORY CT",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209046859",
            "telephone_number": "434-227-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021300",
            "telephone_number": "571-429-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYU",
        "middle_name": "WON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401413863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jieon Kim, D.D.S.
• Jisun Kim
• Junseok Kim
• Justin Sungmin Kim, CRNA
• Katlen Kim, PHARMD
• Maria Kim, MS, RDN, LDN
• Robin S. Kim, D.D.S.
• Samuel Hyojune Kim, MD
• Sara Jihae Kim, PHARMACIST
• Sea Kim, MD

• General Practice Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.