Individual
HAE LIM JI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1911 FORT MYER DR LBBY 101, ARLINGTON, VA 22209-1603
(703) 686-5445
Mailing address
6411 FOUR OAKS LN, BURKE, VA 22015-4024
(703) 307-5618
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02774400
NJ
1223G0001X
General Practice Dentistry
Primary
0401417246
VA
1223G0001X
General Practice Dentistry
060708
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2018
Last updated
05/04/2021
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