DR. SONNY SUNGHUN KIM (NPI# 1700214293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700214293 |
| Entity Type | Individual |
| Full Name | DR. SONNY SUNGHUN KIM |
| Practice Address |
11876 Sunrise Valley Drive 101 Reston VA 20191 |
| Practice Telephone | 7033909191 |
| Practice Fax Number | 7033908887 |
| Mailing Telephone | 7033909191 |
| Mailing Fax Number | 7033908887 |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2013-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 0401007832 | VA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
0401007832 | VA | Dental Providers |
| Street Address |
11876 SUNRISE VALLEY DRIVE 101 |
| City | RESTON |
| State | VA |
| Zip Code | 20191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275150518 | Grace Andales Soistman | Nurse Practitioner | 11160 South Lakes Dr. Reston, Va 20191, Reston, VA 20191 | 2020-07-02 |
| 1790317709 | Twenty Four/7 LLC | Private Vehicle | 11922 Winterthur Ln, 103, Reston, VA 20191 | 2020-02-07 |
| 1437626058 | Aramesh Darvishian Dds Pllc | Dentist | 12040 South Lakes Dr. Suite 200, Reston, VA 20191 | 2018-11-01 |
| 1992282693 | Ashkan Ghods | Home Health | 11760 Sunrise Valley Dr, #405, Reston, VA 20191 | 2018-07-25 |
| 1104319698 | Capital Critical Care & Informatics PC | Internal Medicine | 11890 Sunrise Valley Dr # 442, Reston, VA 20191 | 2018-06-11 |
| 1063930683 | Mackenzie Marie Evans | Specialist/Technologist | 2380 Branleigh Park Ct, Reston, VA 20191 | 2017-09-04 |
| 1073910345 | Jane L Mahan-wiegand | Dietitian, Registered | 1900 Campus Commons Drive, Suite 100, Reston, VA 20191 | 2014-12-02 |
| 1982036786 | Stephanie Lourdes Miller | Physician Assistant | 12040 South Lakes Drive, Suite 207, Generations Family Practice, Reston, VA 20191 | 2013-08-02 |
| 1316250988 | Thao Ngoc Vuong | Pharmacist | 1898 Winterport Cluster, Reston, VA 20191 | 2010-07-23 |
| 1528237625 | Patane & Associates Physical Therapy, LLC | Physical Therapist | 12310 Pinecrest Rd Suite 207, Reston, VA 20191 | 2008-02-22 |
| Find all providers in zip 20191 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811906 | Christine Baek Mcandrew | Dentist | 1950 Roland Clarke Pl Ste 420, Reston, VA 20191-1414 | 2020-08-13 |
| 1346859717 | Arya Mazda Mansouri | Dentist | 1334 Dasher Ln, Reston, VA 20190-3940 | 2020-07-30 |
| 1417587312 | Herndon Modern Dentistry, PC | Dentist | 2537 John Milton Dr., Reston, VA 20171 | 2020-01-20 |
| 1003460718 | Ah Young Hong | Dentist | 1855 Saint Francis St Apt 406, Reston, VA 20190-6249 | 2019-07-31 |
| 1245724806 | Hala Elham Imam | Dentist | 1976 Crescent Park Dr, Reston, VA 20190-3288 | 2018-06-18 |
| 1386013746 | Ksheera Appachu | Dentist | 1855 Saint Francis St Apt 203, Reston, VA 20190-6248 | 2015-09-16 |
| 1558738013 | Julija Kondratyuk | Dentist | 11575 N Shore Dr Apt 1, Reston, VA 20190-4328 | 2015-08-31 |
| 1841677085 | Sepideh Badriahari | Dentist | 11654 Plaza America Dr, 637, Reston, VA 20190-4700 | 2015-04-27 |
| 1205113297 | Joy Jang | Dentist | 1984 Isaac Newton Square W, Suite 100, Reston, VA 20190-5038 | 2011-11-04 |
| 1477708675 | Anthony M Moawad | Dentist | 1886 Metro Center Dr Ste 600, Reston, VA 20190-5299 | 2008-12-02 |
| Find all providers in RESTON | ||||
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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.