Provider Demographics
NPI:1447707260
Name:KIM, ERIC JIHUN (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JIHUN
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21475 RIDGETOP CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-8504
Mailing Address - Country:US
Mailing Address - Phone:703-444-3710
Mailing Address - Fax:
Practice Address - Street 1:21475 RIDGETOP CIR STE 200
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-8504
Practice Address - Country:US
Practice Address - Phone:703-444-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD168711223X0400X
VA04014165111311223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics