Provider Demographics
NPI:1780726927
Name:LUI, KIN (DMD)
Entity type:Individual
Prefix:DR
First Name:KIN
Middle Name:
Last Name:LUI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5138 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1050
Mailing Address - Country:US
Mailing Address - Phone:703-379-0800
Mailing Address - Fax:
Practice Address - Street 1:5138 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1050
Practice Address - Country:US
Practice Address - Phone:703-379-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice