Provider Demographics
NPI:1619969102
Name:RUMANES, KIMON ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMON
Middle Name:ARTHUR
Last Name:RUMANES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13132 BRADLEY FARM DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3827
Mailing Address - Country:US
Mailing Address - Phone:703-437-3156
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Practice Address - Street 2:8901 WISCONSIN AVE.
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0118571223G0001X
CA280791223G0001X
VA04010081881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice