Jerry Chongmin Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401007221 Issued in VA

Practice address

8622 Lee Hwy Ste a
Fairfax, VA 22031-2148

Phone

(703) 876-4600

NPI assigned

Dec 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• J Kim DDS and R Kim DDS PC

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1578721601
  NPD (past) Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750459988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10243 BRITTENFORD DR",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221821867",
            "telephone_number": "703-716-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8622 LEE HWY STE A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312148",
            "telephone_number": "703-876-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JERRY",
        "middle_name": "CHONGMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401007221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Injung Kim
• James Chonghyuk Kim, D.C., P.C.
• Jamie Kim, PMHNP
• Jennifer Kim, D.M.D.
• Jenny Kim
• Jinwook Kim, L.AC.
• Jonathan Kim, OD
• Joseph Jihoon Kim, MA.,CCC-SLP
• Kenneth Jae Yoon Kim, MD
• Kevin Hyungsup Kim, DC, LAC

• General Practice Dentistry in Fairfax, VA
• Providers in Fairfax, 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 8, 2007; 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.