Sooyeon Caritas Ahn, D.M.D.
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · MC Lean, VA
NPI 1699113159 · NPPES record last updated Jun 6, 2013
Key facts
- NPI
- 1699113159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 0401413793 (VA)
- Practice address
- 6845 Elm St
Suite 450
MC Lean, VA 22101-6007 - Phone
- (703) 356-7001
- Fax
- (703) 356-7002
- NPI assigned
- Jun 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14926 | MD | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| DS038496 | PA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 0401413793 | VA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0401413793 | VA | Yes |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS038496 | PA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 14926 | MD |
Addresses
Primary practice location
6845 Elm St
Suite 450
MC Lean, VA 22101-6007
Mailing address
6845 Elm St
Suite 450
MC Lean, VA 22101-6007
Phone (703) 356-7001
Other providers in MC Lean, VA
- Affect Provider Group P.S.C.
- Affect Therapeutics, Inc.
- Nazo Afzal
- Bridgette Paige Aguilar-Dishman
- Kazi Ahmed
- Sara Akbar
- Stephanie O Akoto
- Mohammed Al-Dalli
- Rafee Al-Mansur
- Adam A Albaba
All providers in MC Lean, VA · Orthodontics and Dentofacial Orthopedics Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.