Active NPI
Hanwool Kim, DDS
- General Practice Dentistry
- Fairfax, VA
National Provider Identifier
1609436989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401416449
- Practice address
- 8303 Arlington Blvd Ste 104
Fairfax, VA 22031-2903 - Phone
- (703) 207-0700
- NPI assigned
- Jun 18, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401416449 | VA | Primary |
Addresses
Primary practice location
8303 Arlington Blvd Ste 104
Fairfax, VA 22031-2903
Mailing address
8059 Ashland Ave Apt 11
Manassas, VA 20109-8059
Phone (703) 717-8408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401416449 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kim and Chung DDS, PLLC | Current | Accepting new patients | |
| Edward R Hindman Jr DDS PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- South Riding, VA
- NPI 1093692394
-
- Dentist
- Fairfax, VA
- NPI 1396844098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1609436989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8059 ASHLAND AVE APT 11",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201098059",
"telephone_number": "703-717-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8303 ARLINGTON BLVD STE 104",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312903",
"telephone_number": "703-207-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HANWOOL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-18",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401416449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.