IndividualActive
Dongsup Kim, DDS
NPI 1336207554 · Public Health Dentistry · Fairfax, VA
Provider details
- NPI number
- 1336207554
- Entity type
- Individual
- Primary specialty
- Public Health DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 0401006468 (VA)
Specialties & taxonomies
Dental Providers
Practice location
9901 Braddock Rd
Fairfax, VA 22032-1904
Phone: (703) 323-4024
Fax: (703) 323-4252
Approximate (ZIP-level) locationGet directions
Mailing address
9901 Braddock Rd
Fairfax, VA 22032-1904
Registry dates
- Enumerated
- 2006-12-04
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.