Individual provider Active NPI

Aileen Chyn Kim, DDS

  • Dentist
  • Alexandria, VA
National Provider Identifier
1821357443
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413996 Issued in VA
Practice address
5249 Duke St
Suite L-10
Alexandria, VA 22304-2926
Phone
(703) 823-8812
Fax
(703) 823-8813
NPI assigned
May 16, 2012
Last updated
May 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413996 VA Primary

Addresses

Primary practice location

5249 Duke St
Suite L-10
Alexandria, VA 22304-2926

Mailing address

5249 Duke St
Suite L-10
Alexandria, VA 22304-2926
Phone (703) 823-8812

Other names 1

  • Dr. Aileen Chyn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722002128 PA Order and Referring Only - DentistPractitioner - Dentist 1355634791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BDG Specialty LLC Current Accepting new patients
Graceful Smiles LLC Dentist Current Accepting new patients
Blessed Smiles CurrentSince Feb 23, 2020 Accepting new patients

Locations

5249 Duke St
Ste L10
Alexandria, VA 22304
Phone (703) 823-8812

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1821357443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5249 DUKE ST",
            "address_2": "SUITE L-10",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042926",
            "telephone_number": "703-823-8812",
            "fax_number": "703-823-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 DUKE ST",
            "address_2": "SUITE L-10",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042926",
            "telephone_number": "703-823-8812",
            "fax_number": "703-823-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "AILEEN",
        "middle_name": "CHYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AILEEN",
            "last_name": "CHYN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.