Provider Demographics
NPI:1760690291
Name:KIM, SEJOON SEAN (DDS MD)
Entity Type:Individual
Prefix:DR
First Name:SEJOON
Middle Name:SEAN
Last Name:KIM
Suffix:
Gender:M
Credentials:DDS MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3815 ABALONE CV
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5015
Mailing Address - Country:US
Mailing Address - Phone:281-208-5165
Mailing Address - Fax:
Practice Address - Street 1:830 S MASON RD
Practice Address - Street 2:A-5
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3896
Practice Address - Country:US
Practice Address - Phone:281-392-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery