Provider Demographics
NPI:1093692394
Name:KIM AND CHUNG DDS, PLLC
Entity type:Organization
Organization Name:KIM AND CHUNG DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANWOOL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-717-8408
Mailing Address - Street 1:25154 CUTGRASS TER
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5634
Mailing Address - Country:US
Mailing Address - Phone:703-717-8408
Mailing Address - Fax:
Practice Address - Street 1:25031 RIDING PLZ STE 130
Practice Address - Street 2:
Practice Address - City:SOUTH RIDING
Practice Address - State:VA
Practice Address - Zip Code:20152-5916
Practice Address - Country:US
Practice Address - Phone:703-327-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental