NPIMap

Organization Active NPI

Pearbrite Dental Inc.

  • Prosthodontics
  • Vienna, VA
National Provider Identifier
1407214570
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
0401008847 Issued in VA
Legal business name
PEARBRITE DENTAL INC.
Practice address
301 Maple Ave W Ste 610
Vienna, VA 22180-4300
Phone
(703) 587-4865
NPI assigned
Feb 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Dr. Joongseo KimNPI 1437212826
Title
Owner/ Doctor
Phone
(703) 281-7011

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)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 0401413569 VA
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 0401008847 VA Primary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 12296 MD

Addresses

Primary practice location

301 Maple Ave W Ste 610
Vienna, VA 22180-4300

Mailing address

301 Maple Ave W Ste 610
Vienna, VA 22180-4300
Phone (703) 587-4865

Other names 1

  • pearlbrite dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Franconia Dental Care3 organizations share this tax ID, including this one

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.

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1407214570",
    "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": "703-587-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 610",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804300",
            "telephone_number": "703-587-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARBRITE DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOONGSEO",
        "authorized_official_title_or_position": "OWNER/ DOCTOR",
        "authorized_official_telephone_number": "703-281-7011",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401413569",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401008847",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "12296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pearlbrite dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.

Verify at the official NPI Registry.