Kelly Heejung Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29161 Issued in TX

Practice address

26742 E. University Dr.
Building 200, Suite 220
Aubrey, TX 76227

Phone

(972) 845-1234

Fax

(972) 845-1212

NPI assigned

Aug 28, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Navo Dental Professionals PC

  dba Navo Family Dental

  • General Practice Dentistry
  • Aubrey, TX
  • NPI 1679048292
  NPD (past) Authorized official
• Brident Dental Associates PC

  • Dentist
  • Grand Prairie, TX
  • NPI 1720552607
  NPD (past)
• Brident Dental Associates PC

  • Dentist
  • Fort Worth, TX
  • NPI 1780158881
  NPD (past)
• South Texas Dental Associates, L.P.

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1376797407
  NPD (past)
• South Texas Dental Associates, LP

  • General Practice Dentistry
  • Grand Prairie, TX
  • NPI 1861833782
  NPD (past)

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1760816607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15517 BRYANT PARK AVE",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750781711",
            "telephone_number": "682-308-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26742 E. UNIVERSITY DR.",
            "address_2": "BUILDING 200, SUITE 220",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "76227",
            "telephone_number": "972-845-1234",
            "fax_number": "972-845-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5404 Preston Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750347471",
            "country_code": "US",
            "telephone_number": "972-963-9104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4229 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Ft Worth",
            "state": "TX",
            "postal_code": "761033222",
            "country_code": "US",
            "telephone_number": "817-413-0712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 E Main St",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "75050",
            "country_code": "US",
            "telephone_number": "972-314-4867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KELLY",
        "middle_name": "HEEJUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Ann Kelley, M.S.,CCC-SLP
• Ricardo Kelly Jr.
• Kenyada's Elite Concierge Services LLC
• Mariam M Khan, M.D.
• Kidzania Dental, LLC (Kidzania Pediatric Dentistry)
• Kindred Care LLC (Kindred Care Group Home)
• Kinship Behavioral Health and Support
• Tamara Knapp-Grosz, PH.D.
• Knew Beginnings LLC
• Santhisree Kopalli, MD

• General Practice Dentistry in Aubrey, TX
• Providers in Aubrey, 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 Nov 26, 2018; 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.