Provider Demographics
NPI:1801389929
Name:KYUNG, ERICA (DMD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:KYUNG
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 1:16708 RICHMOND HWY STE 115
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2770
Mailing Address - Country:US
Mailing Address - Phone:703-221-4040
Mailing Address - Fax:
Practice Address - Street 1:16708 RICHMOND HWY STE 115
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2770
Practice Address - Country:US
Practice Address - Phone:703-221-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014181731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry