NPIMap

Organization Active NPI

Timothy Kim &Thomas Kim, DDS, PC

  • General Practice Dentistry
  • Centreville, VA
National Provider Identifier
1497066229
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410634 Issued in VA
Legal business name
TIMOTHY KIM &THOMAS KIM, DDS, PC
Practice address
5900 Fort Dr Ste 209
Centreville, VA 20121-2425
Phone
(703) 378-5777
Fax
(703) 378-5776
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Dr. Thomas S Kim, DDSNPI 1720108533
Title
Vice President
Phone
(703) 378-5777

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 0401410634 VA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 0401410757 VA

Addresses

Primary practice location

5900 Fort Dr Ste 209
Centreville, VA 20121-2425

Mailing address

5900 Fort Dr Ste 209
Centreville, VA 20121-2425
Phone (703) 378-5777

National Provider Directory

National Provider Directory

Locations

5900 Fort Dr
Ste 209
Centreville, VA 20121
Phone (703) 378-5777

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1497066229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 FORT DR STE 209",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212425",
            "telephone_number": "703-378-5777",
            "fax_number": "703-378-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 FORT DR STE 209",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212425",
            "telephone_number": "703-378-5777",
            "fax_number": "703-378-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY KIM &THOMAS KIM, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "703-378-5777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410634",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.