KENNETH J KIM, M.D., P.C. (NPI# 1710381660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710381660 |
| Entity Type | Organization |
| Organization Name | KENNETH J KIM, M.D., P.C. |
| Other Organization Name | KENNETH J KIM PEDIATRICS |
| Practice Address |
3930 Pender Dr Suite 330 Fairfax VA 22030-0985 |
| Practice Telephone | 7032460022 |
| Practice Fax Number | 7032460080 |
| Mailing Telephone | 7032460022 |
| Mailing Fax Number | 7032460080 |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-11-11 |
| Authorized Official Name | KENNETH J. KIM (PRESIDENT) |
| Authorized Official Telephone | 7032460022 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
0101245549 | VA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kenneth J Kim Pediatrics | Doing Business As Name - Organization |
| Street Address |
3930 PENDER DR SUITE 330 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-0985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720088941 | Aram Orthopaedics, P.C. | Orthopaedic Surgery | 3930 Pender Dr, Suite 210, Fairfax, VA 22030-0985 | 2005-07-29 |
| 1003283938 | Mid Atlantic Pain Management, LLC | Anesthesiology | 3930 Pender Dr, Suite 120, Fairfax, VA 22030-0985 | 2015-08-26 |
| 1205212933 | Dermatology of Virginia | Dermatology | 3930 Pender Dr, Suite 210, Fairfax, VA 22030-0985 | 2015-08-04 |
| 1265829253 | Anna Rich | Hearing Instrument Specialist | 3930 Pender Dr, Ste 140, Fairfax, VA 22030-0985 | 2015-04-17 |
| 1144631276 | Obgyn of Virginia, LLC | Obstetrics & Gynecology | 3930 Pender Dr, Suite 60, Fairfax, VA 22030-0985 | 2014-05-12 |
| 1154769040 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 3930 Pender Dr, Suite 210, Fairfax, VA 22030 | 2013-06-12 |
| 1144569732 | Lyle Joseph Ritch | Physician Assistant | 3930 Pender Dr, Suite 210, Fairfax, VA 22030-0985 | 2013-02-03 |
| 1922356054 | Fairfax Loudoun Obgyn, Inc | Obstetrics & Gynecology | 3930 Pender Dr, Suite 210, Fairfax, VA 22030-0985 | 2012-08-21 |
| 1073887741 | Saman Madani Dmd & Shadi Shareghi Dds PC | Dentist | 3930 Pender Dr, Suite #250, Fairfax, VA 22030-0985 | 2012-02-28 |
| 1598085722 | Applied Neuropsychological Services PC | Clinical Neuropsychologist | 3930 Pender Dr, Suite 320, Fairfax, VA 22030-0985 | 2010-06-10 |
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| 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 |
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| 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 |
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| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1508386483 | James E Long, Md, PC | Clinic/Center | 8316 Arlington Blvd Ste 650, Fairfax, VA 22031-5216 | 2017-06-22 |
| 1962857318 | Joann Pfundstein, Md, LLC | Clinic/Center | 3020 Hamaker Ct, Suite B102, Fairfax, VA 22031-2238 | 2016-05-03 |
| 1346526043 | Gil U. Kim, Md PC | Clinic/Center | 8316 Arlington Blvd Ste 514, Fairfax, VA 22031-5216 | 2011-10-25 |
| 1386878999 | Siavash Sobhani M.d. P.C. | Clinic/Center | 3650 Joseph Siewick Dr Ste 107, Fairfax, VA 22033-1711 | 2009-05-11 |
| 1942451695 | Virginia Advanced Medical Center, PC | Clinic/Center | 3930 Pender Dr Ste 320, Fairfax, VA 22030-0986 | 2008-09-30 |
| 1144497082 | Wynn Family Medicine, Pllc | Clinic/Center | 8316 Arlington Blvd, Suite 234, Fairfax, VA 22031-5207 | 2008-05-09 |
| 1770753097 | Star Family Medicine | Clinic/Center | 3915 Old Lee Hwy, Unit 21-c, Fairfax, VA 22030-2432 | 2008-03-03 |
| 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.