Provider Demographics
NPI:1093935710
Name:KIM, ALLAN S (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:S
Last Name:KIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:SIN
Other - Middle Name:D
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:11921 ROCKVILLE PIKE
Mailing Address - Street 2:STE 410
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-230-9222
Mailing Address - Fax:301-230-9337
Practice Address - Street 1:11921 ROCKVILLE PIKE
Practice Address - Street 2:STE 410
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-230-9222
Practice Address - Fax:301-230-9337
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13349122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist