Provider Demographics
NPI:1528285913
Name:KIM, DUKE H (DDS MAGD)
Entity type:Individual
Prefix:DR
First Name:DUKE
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N TAYLOR STREET
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203
Mailing Address - Country:US
Mailing Address - Phone:703-931-5555
Mailing Address - Fax:703-778-4098
Practice Address - Street 1:900 N TAYLOR STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:703-931-5555
Practice Address - Fax:703-778-4098
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA7158122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist