Matthew Peter Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412192 Issued in VA

Practice address

14535 John Marshall Hwy
Gainesville, VA 20155-4023

Phone

(703) 753-2252

Fax

(703) 753-9832

NPI assigned

Jun 26, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1720240294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14535 JOHN MARSHALL HWY",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554023",
            "telephone_number": "703-753-2252",
            "fax_number": "703-753-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 JOHN MARSHALL HWY",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554023",
            "telephone_number": "703-753-2252",
            "fax_number": "703-753-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MATTHEW",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Khalil, MD
• John Hassan Khouri, D.M.D.
• Natasha Khurana, DDS, IBCLC
• Jason P. Kiangsoontra, DDS, MS, FACP
• Dae Young Kim
• Christopher Kirby, DPT
• Mary Elizabeth Kirkpatrick
• Ludmila Marie Kissi, M.D.
• KLC Counseling Services, LLC
• KND Development 59 LLC

• General Practice Dentistry in Gainesville, VA
• Providers in Gainesville, 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 Jul 2, 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.