Kook Sun Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40802 Issued in TX

Practice address

2510 Bardin Rd Ste 800
Grand Prairie, TX 75052-3838

Phone

(972) 623-0200

NPI assigned

Jul 23, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Alar Dental

  • Dental Clinic/Center
  • Grand Prairie, TX
  • NPI 1043815574
  NPD
• Moncrief Army Community Hospital

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Columbia, SC
  • NPI 1932304946
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1164031431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 BARDIN RD STE 800",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523838",
            "telephone_number": "972-623-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BARDIN RD STE 800",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523838",
            "telephone_number": "972-623-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4323 Hill St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292076022",
            "country_code": "US",
            "telephone_number": "803-751-5178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KOOK",
        "middle_name": "SUN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11703586-9922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waleed Khan, MD
• Geeta Khare
• Cynthia Kidd, OTR
• Kids Can Fly Foundation
• Joseph Yun Kim, MD
• Kimberly M Parson DDS PLLC
• Antoinette Kincaid
• Kindcare Health
• Kiner Speech Services
• Kintsugi Dental PLLC

• General Practice Dentistry in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.