NPIMap

Organization Active NPI

Pearlbrite Dental Inc

  • Prosthodontics
  • Alexandria, VA
National Provider Identifier
1902345796
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
0401008847 Issued in VA
Legal business name
PEARLBRITE DENTAL INC
Practice address
6180 Grovedale CT Ste 100
Alexandria, VA 22310-2552
Phone
(703) 922-0031
Fax
(703) 922-9101
NPI assigned
Feb 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Dr. Joongseo Kim, D.D.D
Title
Owner
Phone
(703) 922-0031

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 0401008847 VA
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 0401008847 VA Primary

Addresses

Primary practice location

6180 Grovedale CT Ste 100
Alexandria, VA 22310-2552

Mailing address

6180 Grovedale CT Ste 100
Alexandria, VA 22310-2552
Phone (703) 922-0031

Other names 1

  • Franconia Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Franconia Dental Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6180 Grovedale Ct
#100
Alexandria, VA 22310
Phone (703) 922-0031

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1902345796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6180 GROVEDALE CT STE 100",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102552",
            "telephone_number": "703-922-0031",
            "fax_number": "703-922-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6180 GROVEDALE CT STE 100",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102552",
            "telephone_number": "703-922-0031",
            "fax_number": "703-922-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLBRITE DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOONGSEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-922-0031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008847",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401008847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franconia Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.