Individual
DR. SANDRA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4379 RIDGEWOOD CENTER DR STE 102, WOODBRIDGE, VA 22192-8323
(703) 680-7950
(703) 680-7953
Mailing address
2333 ONTARIO RD NW, WASHINGTON, DC 20009-2627
(202) 483-4922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401412651
VA
122300000X
Dentist
15220
MD
122300000X
Dentist
Primary
DEN1000804
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200285280
—
IN
Enumeration date
01/13/2006
Last updated
04/08/2021
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