Healthcare Provider Details
I. General information
NPI: 1386393940
Provider Name (Legal Business Name): AK ENDODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2022
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5900 HUBBARD DR
NORTH BETHESDA MD
20852-4823
US
IV. Provider business mailing address
5900 HUBBARD DR
NORTH BETHESDA MD
20852-4823
US
V. Phone/Fax
- Phone: 301-377-8306
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANA
KIM
Title or Position: DMD
Credential:
Phone: 301-377-8306