Young Min Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401415708 Issued in VA

Practice address

24565 Dulles Landing Dr Unit 190
Sterling, VA 20166-2714

Phone

(703) 542-7600

NPI assigned

May 31, 2017

Last updated

Jun 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OH

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Young Kim DDS of Centreville PLLC

  • Dental Clinic/Center
  • Centreville, VA
  • NPI 1609619774
  NPD Authorized official
• Young Kim DDS of Lake Manassas PLLC

  dba Lake Manassas Dental Center

  • Dental Clinic/Center
  • Gainesville, VA
  • NPI 1811683667
  NPD Authorized official

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1437687605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41713 MCMONAGLE SQ",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201056028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24565 DULLES LANDING DR UNIT 190",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201662714",
            "telephone_number": "703-542-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13880 Braddock Rd Ste 311",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "VA",
            "postal_code": "201212462",
            "country_code": "US",
            "telephone_number": "704-941-4332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG",
        "middle_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Kim, DC
• Hyunkyung Kim
• Jiin Kim
• John Ho Kim, DDS
• Kenneth Su Kim, M.D.
• Yujin Kim
• Daphne King, ED.D
• Stacey King
• Damara Joi Kippins-Graham
• Keyona Kirlew

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.