Graceful Smiles LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GRACEFUL SMILES LLC

Practice address

6120 Brandon Ave Ste 317
Springfield, VA 22150-2504

Phone

(703) 451-3303

NPI assigned

Dec 5, 2020

Organization subpart

No

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

Authorized official

Name

Andrew Kim

Title

Manager

Phone

(703) 677-7202

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aileen Chyn Kim, DDS

  • Dentist
  • Alexandria, VA
  • NPI 1821357443
  NPD
• Sang-Jin Samuel Nam, DDS

  • General Practice Dentistry
  • Springfield, VA
  • NPI 1164910154
  NPD
• Sarah Kennealy, DDS

  • Dentist
  • Alexandria, VA
  • NPI 1821359456
  NPD (past)

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607126400000",
    "number": "1740886860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 BRANDON AVE STE 317",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221502504",
            "telephone_number": "703-451-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 BRANDON AVE STE 317",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221502504",
            "telephone_number": "703-451-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-05",
        "last_updated": "2020-12-05",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-677-7202"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodheart Healthcare Services, Inc. (Goodheart Home Healthcare Services)
• Gary Lee Gordon, LCSW
• Lisa G Gordon, LCSW
• Grace Chang, OD PC
• Grace Home Care, LLC
• Patrice Graham
• Jason Grainer, PH.D.
• Kimberly Elizabeth Grant, PHARMD
• Magnus Grant
• Stephen Grant

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; 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.