Active NPI
Kyeongseon Kim, DDS
- General Practice Dentistry
- McKinney, TX
National Provider Identifier
1073601480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22301
- Practice address
- 1717 W University Dr Ste410
McKinney, TX 75069 - Phone
- (972) 547-0066
- Fax
- (972) 547-0069
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22301 | TX | Primary |
Addresses
Primary practice location
1717 W University Dr Ste410
McKinney, TX 75069
Mailing address
1717 W University Dr Ste 410
McKinney, TX 75069
Phone (972) 547-0066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22301 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyeongseon Kim, DDS, PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- McKinney, TX
- NPI 1255584546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233619200000",
"number": "1073601480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 W UNIVERSITY DR STE 410",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "75069",
"telephone_number": "972-547-0066",
"fax_number": "972-547-0069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 W UNIVERSITY DR STE410",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "75069",
"telephone_number": "972-547-0066",
"fax_number": "972-547-0069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KYEONGSEON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2009-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "22301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.