Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. SEAN SANGMIN KIM
NPI 1477182467
Dentist in Philadelphia, PA

Q: What is Sean Kim's NPI number?

The NPI number for Sean Kim is 1477182467. It was assigned to this individual provider in the NPPES registry on April 2, 2020.

Q: What is Sean Kim's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Kim was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 02, 2020PECOS Enrolled

3223 N BROAD ST, PHILADELPHIA, PA 19140(215) 707-2871 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 29, 2026, Apr 6, 2026, Aug 20, 2021 and 1 more (4 updates tracked since 2020).

On this page

About Mr. Sean Sangmin Kim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SEAN SANGMIN KIM (NPI 1477182467) is an individual dentist in Philadelphia, Pennsylvania, licensed in Pennsylvania (DS043222) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Columbia University College Of Dental Medicine (2020).

NPPES Registry Identity

NPI1477182467

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameMR. SEAN SANGMIN KIM

Location Address3223 N BROAD STPhiladelphia, PA 19140-5007

Mailing Address3223 N Broad StPhiladelphia, PA 19140-5007

Phone(215) 707-2871

Sole ProprietorNo

Medical School CMSColumbia University College Of Dental MedicineGraduated 2020

Enumeration DateApril 2, 2020

Last NPPES UpdateSeptember 29, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2026

✔ NPI 1477182467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in PA · DS043222

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License DS043222 (PA)

3223 N BROAD ST, Philadelphia, PA 19140

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Secondary Practice Locations 2

Location 12200 Arch St Ste 102Philadelphia, PA 19103-1353 · Phone (215) 515-2881 · Fax (267) 715-5566

Location 21685 Crown AveLancaster, PA 17601-6322 · Phone (717) 481-7645

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Sean Sangmin Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204239320

PECOS Enrollment IDI20251111002788

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sean Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

PA Surgery Group LLC

3.4 mi

Oral and Maxillofacial Surgery

2200 ARCH ST STE 102
Philadelphia, PA 19103

Reassigned Medicare billing, Pennsylvania enrollment
2 clinicians in this Medicare group

NPI 1891477162 (215) 515-2881

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19140 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN PAUL FRIEL JR. DDS

Dentist (General Practice)