Seonjeong Kim
NPI 1528246162 · General Practice Dentistry · Prescott Valley, AZ
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1528246162
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 7074 (AZ)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 51 Brian Mickelsen PkwyCottonwood, AZ 86326-3610Phone: (928) 639-8132
Registry dates
- Enumerated
- 2008-02-06
- Last updated
- 2026-06-02
- Certified
- 2026-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.