Sonny Sunghun Kim

Primary specialty

DentistTaxonomy code 122300000X

License

0401007832 Issued in VA

Practice address

11876 Sunrise Valley Drive
101
Reston, VA 20191

Phone

(703) 390-9191

Fax

(703) 390-8887

NPI assigned

Oct 22, 2013

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

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1700214293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11876 SUNRISE VALLEY DRIVE",
            "address_2": "101",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20191",
            "telephone_number": "703-390-9191",
            "fax_number": "703-390-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11876 SUNRISE VALLEY DRIVE",
            "address_2": "101",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20191",
            "telephone_number": "703-390-9191",
            "fax_number": "703-390-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SONNY",
        "middle_name": "SUNGHUN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007832",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401007832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidscare Home Health of Virginia LLC
• Ellen Christina Kiel, L.C.S.W.
• Alice Kim, RPH
• Hannah Kim, AU.D., CCC-A
• Jeong I Kim
• Soo Chan Kim
• Soojin Kim, MD
• Erin Helena Kimmelman, BCBA
• Daniel M Kimonyi
• Margaret King, O.G.N.P.

• Dentist in Reston, VA
• Providers in Reston, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.