Active NPI
Kelly Seojung Kim, DDS
- Dentist
- Carrollton, TX
National Provider Identifier
1750011078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 063409
- Practice address
- 2414 Marsh LN
Carrollton, TX 75006-2126 - Phone
- (972) 526-0181
- NPI assigned
- Jun 11, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 063409 | NY | Primary |
| Dentist | 122300000X | 39010 | TX |
Addresses
Primary practice location
2414 Marsh LN
Carrollton, TX 75006-2126
Mailing address
2414 Marsh LN
Carrollton, TX 75006-2126
Phone (972) 526-0181
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 |
|---|---|---|---|
| 063409 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Titanium Dental PLLC | 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
- Tuckahoe, NY
- NPI 1790636553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1750011078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2414 MARSH LN",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750062126",
"telephone_number": "972-526-0181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 MARSH LN",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750062126",
"telephone_number": "972-526-0181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KELLY",
"middle_name": "SEOJUNG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-11",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "063409",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "39010",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.