SEONJEONG KIM - NPI 1528246162 - Dentist in Prescott Valley, AZ

Q: What is Seonjeong Kim's NPI number?

The NPI number for Seonjeong Kim is 1528246162. It was assigned to this individual provider in the NPPES registry on February 6, 2008.

Q: What is Seonjeong Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Seonjeong Kim was last updated on June 2, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Seonjeong Kim NPPES

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

SEONJEONG KIM (NPI 1528246162) is an individual general practice provider in Prescott Valley, Arizona, licensed in Arizona (7074) and active in the NPI registry since February 2008. She is enrolled in Medicare PECOS and maintains a secondary practice location in Cottonwood.

NPPES Registry Identity

NPI1528246162

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameSEONJEONG KIM

Location Address3212 N WINDSONG DR STE 200Prescott Valley, AZ 86314-2255

Mailing Address3212 N Windsong Dr Ste 200Prescott Valley, AZ 86314-2255 · (928) 583-1000

Phone(928) 583-1000

Sole ProprietorYes

Enumeration DateFebruary 6, 2008

Last NPPES UpdateJune 2, 2026

NPPES CertifiedJune 2, 2026

✔ NPI 1528246162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in AZ · 7074

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3212 N WINDSONG DR STE 200, Prescott Valley, AZ 86314

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Secondary Practice Location 1

Location 151 Brian Mickelsen PkwyCottonwood, AZ 86326-3610 · Phone (928) 639-8132

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86314 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

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 5

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

MS. CATHERINE N REID-MCKEE NP

Nurse Practitioner