Individual provider Active NPI

Kristen Kae Seely

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1629142179
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21001 Issued in TX
Practice address
1450 Preston Forest SQ
Ste. 264
Dallas, TX 75230-2746
Phone
(972) 233-2686
Fax
(972) 233-8097
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21001 TX Primary

Addresses

Primary practice location

1450 Preston Forest SQ
Ste. 264
Dallas, TX 75230-2746

Mailing address

1450 Preston Forest SQ
Ste. 264
Dallas, TX 75230-2746
Phone (972) 233-2686

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

LicenseStateTypeSpecialty
21001TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629142179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 PRESTON FOREST SQ",
            "address_2": "STE. 264",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302746",
            "telephone_number": "972-233-2686",
            "fax_number": "972-233-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 PRESTON FOREST SQ",
            "address_2": "STE. 264",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302746",
            "telephone_number": "972-233-2686",
            "fax_number": "972-233-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELY",
        "first_name": "KRISTEN",
        "middle_name": "KAE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.