JUNG S PAK DDS PC (NPI# 1366864480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366864480 |
| Entity Type | Organization |
| Organization Name | JUNG S PAK DDS PC |
| Other Organization Name | FAIRFAX DENTAL CARE |
| Practice Address |
11001 Lee Hwy Ste A Fairfax VA 22030-5018 |
| Practice Telephone | 7036919740 |
| Practice Fax Number | 7036919809 |
| Mailing Telephone | 7036919740 |
| Mailing Fax Number | 7036919809 |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |
| Authorized Official Name | DR. JUNG SOO PAK (DIRECTOR) |
| Authorized Official Telephone | 7036919740 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Fairfax Dental Care | Doing Business As Name - Organization |
| Street Address |
11001 LEE HWY STE A |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-5018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639338510 | Eric R Capps | Dentist | 11001 Lee Hwy Ste A, Fairfax, VA 22030-5018 | 2008-06-05 |
| 1164749925 | Ryan Javier | Dentist | 11001 Lee Hwy Ste A, Fairfax, VA 22030-5018 | 2010-05-03 |
| 1851548044 | Thien V Le | Dentist | 11001 Lee Hwy Ste A, Fairfax, VA 22030-5018 | 2008-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053873240 | Merrifield Dental Associates | Clinic/Center | 3025 Hamaker Ct Ste 420, Fairfax, VA 22031-2237 | 2019-04-05 |
| 1790124949 | Georges Traboulsi Dds PC | Clinic/Center | 3946 Kathryn Jean Ct, Fairfax, VA 22033-2739 | 2013-06-20 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1023287737 | Naturadent, P.C. | Clinic/Center | 9508a Lee Hwy, Fairfax, VA 22031-2303 | 2008-02-27 |
| 1932292877 | William B Sherman Dds PC | Clinic/Center | 9500 B Lee Highway, Fairfax, VA 22031 | 2006-10-02 |
| 1205897378 | Spencer B Wagner Dmd PC | Clinic/Center | 1987 Allendale Fairfax Hwy, Fairfax, SC 29827-9137 | 2006-03-29 |
| 1710477815 | Pd Dental Pllc | Clinic/Center | 10721 Main St Ste 100, Fairfax, VA 22030-6913 | 2018-05-14 |
| 1831606086 | Jhia-ming Chang, Dds, PC | Clinic/Center | 11208 Waples Mill Rd Ste 100, Fairfax, VA 22030-6077 | 2018-01-09 |
| 1336661651 | Jones Family Dentistry Pllc | Clinic/Center | 3879 Plaza Dr, Fairfax, VA 22030-2512 | 2017-07-07 |
| 1518330133 | Optimal Dental Center, Inc | Clinic/Center | 8303 Arlington Blvd, Suite 107, Fairfax, VA 22031-2903 | 2015-11-04 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.