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General NPI Number Information
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NPI Number | 1568080414
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Entity Type | Individual
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Provider Name | SHAWN J KIM DMD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 2550 S CLARK ST STE 100A
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City | ARLINGTON
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State | VA
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Zip | 22202-3962
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Country | US
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Telephone | 703-223-8728
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 MAYLAND DR STE A
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City | RICHMOND
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State | VA
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Zip | 23294-4648
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Country | US
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Telephone | 509-768-2249
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN2000225
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401417353
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License Number State | VA
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