Individual
KIM QUY DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8303 ARLINGTON BLVD, SUITE 101, FAIRFAX, VA 22031-2903
(703) 876-2606
(703) 876-2627
Mailing address
8303 ARLINGTON BLVD, SUITE 101, FAIRFAX, VA 22031-2903
(703) 876-2606
(703) 876-2627
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401006973
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000039191
DENTAL BENEFIT PROVIDERS
—
01
—
0084916
ANTHEM
—
01
—
54-121-44
AETNA HEALTH PLAN
—
05
—
9178677
—
VA
Enumeration date
07/24/2006
Last updated
07/09/2007
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