Seonjeong Kim

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7074 Issued in AZ

Practice address

3212 N Windsong Dr Ste 200
Prescott Valley, AZ 86314-2255

Phone

(928) 583-1000

NPI assigned

Feb 6, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: dontknow.kim.p1@direct.ycchs.nextgenshare.com

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1528246162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 N WINDSONG DR STE 200",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142255",
            "telephone_number": "928-583-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 N WINDSONG DR STE 200",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142255",
            "telephone_number": "928-583-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Brian Mickelsen Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863263610",
            "country_code": "US",
            "telephone_number": "928-639-8132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEONJEONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "7074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth E. Holland, Jr., DDS, Ms, PC
• Brea Kern, DNP, FNP-C
• Kevin F Brown DO LLC
• Lily Mei Kha
• Amy S Kille, PHARM.D.
• Kin Care LLC
• Carrie Kinsey, CPM
• Roberta Knowles
• Hillary Koh, DDS
• Kokopelli Eye Care Optical Dept

• General Practice Dentistry in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.