Peter HD Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10073 Issued in VA

Legal business name

PETER HD KIM, DDS

Practice address

14136 Minnieville Rd
Woodbridge, VA 22193-2313

Phone

(703) 583-4466

Fax

(703) 583-4477

NPI assigned

Nov 17, 2011

Last updated

Nov 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jina Kim

Title

Office Manager

Phone

(703) 583-4466

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Bilal Ali, DDS

  • General Practice Dentistry
  • Woodbridge, VA
  • NPI 1245963347
  NPD (past)
• Hee Don Kim, DDS

  • Dentist
  • Woodbridge, VA
  • NPI 1790720951
  NPD (past)

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1437426509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14136 MINNIEVILLE RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221932313",
            "telephone_number": "703-583-4466",
            "fax_number": "703-583-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14136 MINNIEVILLE RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221932313",
            "telephone_number": "703-583-4466",
            "fax_number": "703-583-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER HD KIM, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-583-4466",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "10073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, 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 Nov 17, 2011; 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.