DR. JERRY CHONGMIN KIM (NPI# 1750459988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750459988 |
| Entity Type | Individual |
| Full Name | DR. JERRY CHONGMIN KIM |
| Credential | DDS |
| Practice Address |
8622 Lee Hwy Ste A Fairfax VA 22031-2148 |
| Mailing Address |
10243 Brittenford Dr Vienna VA 22182-1867 |
| Practice Telephone | 7038764600 |
| Mailing Telephone | 7037160769 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401007221 | VA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912295510 | Jerry J Kim | Surgery | 160 E Artesia St Ste 202, Pomona, CA 91767-2900 | 2011-07-16 |
| 1083716856 | Jerry Hyun Kim | Anesthesiology | 1959 Ne Pacific St, C-212, Box 356340, Seattle, WA 98195-6340 | 2006-09-02 |
| 1548276777 | Jerry Byungho Kim | Emergency Medicine | 4101 Torrance Blvd, Emergency Department, Torrance, CA 90503-4607 | 2006-07-31 |
| 1164492708 | Jerry Y Kim | Anesthesiology | 12251 S 80th Ave, Palos Community Hospital, Palos Heights, IL 60463-1256 | 2006-01-25 |
| Street Address |
8622 LEE HWY STE A |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144398223 | Calvin Khanh Nguyen | Dentist | 8622 Lee Hwy Ste A, Fairfax, VA 22031-2148 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910358 | Erica Vetter | Dentist | 10525 Braddock Rd Ste 9a, Fairfax, VA 22032-2257 | 2020-07-31 |
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1194367623 | Ruhee Jaffer | Dentist | 11213 Lee Hwy Ste A, Fairfax, VA 22030-5698 | 2019-10-16 |
| 1093367310 | Gina Genevia Askander | Dentist | 2810 Old Lee Hwy Ste 200a, Fairfax, VA 22031-4376 | 2019-07-16 |
| 1609436989 | Hanwool Kim | Dentist | 8303 Arlington Blvd Ste 104, Fairfax, VA 22031-2903 | 2019-06-18 |
| 1942776182 | Sapphire Dental Pllc | Dentist | 8622 Lee Hwy, Fairfax, VA 22031-2173 | 2018-10-15 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1710496294 | Fairfax Dentistry, Pllc | Dentist | 11351 Random Hills Rd Ste 102, Fairfax, VA 22030-6081 | 2017-09-27 |
| 1558886580 | Marc Dh Eun | Dentist | 4511 Plateau Dr, Fairfax, VA 22030-6281 | 2017-08-10 |
| 1639603459 | Kouros Hedayati, Dds, Plc | Dentist | 3545 Chain Bridge Rd Ste 5, Fairfax, VA 22030-2708 | 2017-04-18 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.