NPIMap

Organization Active NPI

Virginia Orthodontics and Periodontics

  • Periodontics
  • Vienna, VA
National Provider Identifier
1942568258
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401412796 Issued in VA
Legal business name
VIRGINIA ORTHODONTICS AND PERIODONTICS
Practice address
301 Maple Ave W Ste 440
Vienna, VA 22180-4301
Phone
(703) 539-9166
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Eunyoung Kim
Title
Dr
Phone
(703) 539-9166

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 0401412796 VA Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 0401412701 VA

Addresses

Primary practice location

301 Maple Ave W Ste 440
Vienna, VA 22180-4301

Mailing address

301 Maple Ave W Ste 440
Vienna, VA 22180-4301
Phone (703) 539-9166

National Provider Directory

National Provider Directory

Locations

301 Maple Ave W
Ste 440
Vienna, VA 22180
Phone (703) 539-9166

Practitioners & affiliated clinicians

Practitioners 2

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": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1942568258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 440",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804301",
            "telephone_number": "703-539-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE W STE 440",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804301",
            "telephone_number": "703-539-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA ORTHODONTICS AND PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "EUNYOUNG",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "703-539-9166"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401412796",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401412701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.