Active NPI
Christine Kim, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fairfax, VA
National Provider Identifier
1891931143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 0401411468
- Practice address
- 10614 Warwick Ave Ste B
Fairfax, VA 22030-3060 - Phone
- (703) 383-3434
- NPI assigned
- Dec 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0401411468 | VA | Primary |
Addresses
Primary practice location
10614 Warwick Ave Ste B
Fairfax, VA 22030-3060
Mailing address
1403 Woodhurst Blvd
MC Lean, VA 22102-2234
Phone (703) 848-0142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401411468 | VA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229385600000",
"number": "1891931143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1403 WOODHURST BLVD",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221022234",
"telephone_number": "703-848-0142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10614 WARWICK AVE STE B",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220303060",
"telephone_number": "703-383-3434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-16",
"last_updated": "2008-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "VA",
"license": "0401411468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.