Youngdae Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401415145 Issued in VA

Practice address

5417D Backlick Rd
Springfield, VA 22151-3915

Phone

(703) 988-3386

Fax

(703) 988-3389

NPI assigned

Jan 10, 2014

Last updated

Aug 1, 2016By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Yk Dental Centreville PC

  dba YK Dental Care

  • Dental Clinic/Center
  • Centreville, VA
  • NPI 1528558350
  NPD Authorized official
• Yk Dental Chantilly PC

  • Dental Clinic/Center
  • Chantilly, VA
  • NPI 1316696933
  NPD Authorized official
• Yk Dental PC

  • Dental Clinic/Center
  • Springfield, VA
  • NPI 1235682790
  NPD (past) Authorized official

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1841612744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5417D BACKLICK RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221513915",
            "telephone_number": "703-988-3386",
            "fax_number": "703-988-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5417D BACKLICK RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221513915",
            "telephone_number": "703-988-3386",
            "fax_number": "703-988-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNGDAE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-10",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039841",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415145",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Paul Kim, O.D.
• Jong-Yoon Kim
• Kenneth Yong Kim, DC
• Seung Wook Kim, D.D.S
• Yong Hyun Kim, D.M.D.
• Kings Park Dental, LLC (Kings Park Family Dental)
• Megan Kathleen Kipp, LCSW
• Ginger Lynne Kirk, L.P.C.
• Athena Kirkham
• Sierra Kirkpatrick

• General Practice Dentistry in Springfield, VA
• Providers in Springfield, 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 Aug 1, 2016; 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.