Jae Kwon Bok

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401411726 Issued in VA

Practice address

7535 Little River Tpke
# 100 E
Annandale, VA 22003-2937

Phone

(703) 336-3818

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Jae Kwon Bok DDS PC

  • Dentist
  • Annandale, VA
  • NPI 1164692448
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201996800000",
    "number": "1487756441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7535 LITTLE RIVER TPKE",
            "address_2": "# 100 E",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032937",
            "telephone_number": "703-336-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7535 LITTLE RIVER TPKE",
            "address_2": "# 100 E",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032937",
            "telephone_number": "703-336-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOK",
        "first_name": "JAE KWON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2008-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411726",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blossom Fatima Home Care
• BMR-3 VA, LLC (American Senior Care)
• Body Kinetics Rehab LLC.
• Body Mechanix and Beyond LLC
• Kelly Bojan, RIC, PLPC
• Diane Bonilla, LPC
• Hugo A Bonilla, DDS, MS
• Amanda Boostrom, RDN
• Born Acupuncture
• Ana Maria Born, MD

• General Practice Dentistry in Annandale, VA
• Providers in Annandale, 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 Feb 3, 2008; 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.