Provider Demographics
NPI:1003139320
Name:KIN LUI D.M.D., PC
Entity Type:Organization
Organization Name:KIN LUI D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-683-6688
Mailing Address - Street 1:1500 KING ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2730
Mailing Address - Country:US
Mailing Address - Phone:703-683-6688
Mailing Address - Fax:703-683-6690
Practice Address - Street 1:1500 KING ST STE 300
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2730
Practice Address - Country:US
Practice Address - Phone:703-683-6688
Practice Address - Fax:703-683-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty