NPIMap

Organization Active NPI

Kim Ierna Kitchen DDS, PC

  • General Practice Dentistry
  • Alexandria, VA
National Provider Identifier
1477154516
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KIM IERNA KITCHEN DDS, PC
Practice address
500 Montgomery St Ste 250
Alexandria, VA 22314-1558
Phone
(703) 836-7000
NPI assigned
Nov 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Dr. Kim Ierna Kitchen, DDSNPI 1356552277
Title
Owner/Dentist
Phone
(703) 836-7000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

500 Montgomery St Ste 250
Alexandria, VA 22314-1558

Mailing address

500 Montgomery St Ste 250
Alexandria, VA 22314-1558
Phone (703) 836-7000

Other identifiers 1

IdentifierTypeStateIssuer
1134350853OtherASSOCIATE DENTIST

Other names 1

  • Old Town Smiles Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@oldtownsmiles.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1477154516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MONTGOMERY ST STE 250",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141558",
            "telephone_number": "703-836-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MONTGOMERY ST STE 250",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141558",
            "telephone_number": "703-836-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM IERNA KITCHEN DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "KITCHEN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "IERNA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "703-836-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSOCIATE DENTIST",
            "identifier": "1134350853",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@oldtownsmiles.com",
            "affiliation": "N",
            "endpointDescription": "office e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Montgomery St Ste 250",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223141558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Old Town Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.