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General NPI Number Information
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NPI Number | 1760544993
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Entity Type | Individual
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Provider Name | YOUNG HOON KIM DMD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 12/25/2007
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Provider Practice Location Address
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Address Line | 9000 FERN PARK DR UNIT A2
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City | BURKE
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State | VA
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Zip | 22015-1602
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Country | US
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Telephone | 703-425-1846
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Fax |
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Provider Business Mailing Address
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Address Line | 43850 HEATHERSTONE TER #308
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City | LEESBURG
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State | VA
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Zip | 20176-3419
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Country | US
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Telephone | 703-723-7451
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS036561L
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License Number State | PA
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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 | 0401411246
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License Number State | VA
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