Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114906575 Individual Practitioner Female Practitioner

Dr. Sandra Kim , DMD

Dentist • Woodbridge, VA

Professional Overview & Biography Verified Profile Summary

Dr. Sandra Kim, DMD is a registered healthcare professional specializing in Dentist in Woodbridge, VA. Practice services are available at 4379 RIDGEWOOD CENTER DR STE 102 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4379 Ridgewood Center Dr Ste 102

Woodbridge, VA 221928323

Telephone 7036807950
Fax 7036807953
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Woodbridge, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.7 Yrs
Regional Practice Density
59 Specialists

Practicing in Woodbridge, VA (2514 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-04-08
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License DC DEN1000804

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License MD 15220

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License VA 0401412651

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200285280 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003058538

Doctor of Medicine (M.D.)

Dr. Adele Young , PNP, PhD

Nurse Practitioner - Pediatrics

NPI 1013153220

Pediatric Nurse Practitioner, Doctor of Philosophy (Ph.D.)

Pablo Ruck Troncoso

Dentist - General Practice

NPI 1023476363
Dr. Michael Smith , MD

Obstetrics & Gynecology

NPI 1053302513

Doctor of Medicine (M.D.)

Jacqueline Rodriguez , LCSW

Social Worker - Clinical

NPI 1063784320

Licensed Clinical Social Worker

Teresa Rose , FNP-C

Nurse Practitioner - Family

NPI 1073166096

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Business Mailing Address April 08, 2021

Registered at 2333 ONTARIO RD NW, WASHINGTON, DC 200092627 (Tel: 2024834922)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 08, 2021

Dentist (License #DEN1000804 in DC)

NPI Profile Active January 21, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location January 21, 2014

Registered at 4379 RIDGEWOOD CENTER DR STE 102, WOODBRIDGE, VA 221928323 (Tel: 7036807950)

📍
Updated Business Mailing Address January 21, 2014

Registered at 4379 RIDGEWOOD CENTER DR STE 102, WOODBRIDGE, VA 221928323 (Tel: 7036807950)

👤
Provider Name / Credentials Updated January 21, 2014

Recorded as SANDRA KIM, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 21, 2014

Dentist (License #0401412651 in VA)

🟢
Initial NPI Registration & Enumeration January 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114906575
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 13, 2006
Last Update: April 08, 2021
Sole Proprietor: No

Mailing Address

2333 Ontario Rd Nw

Washington, DC 200092627

Phone: 2024834922

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.