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Casey Seol Kim

Dentist β€’ Columbus, OH

Active NPI 1962199364 Individual Practitioner Female Practitioner
Practice location in NPPES

305 W 12th Ave
Columbus, OH 432101267

Call 6146883763 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

305 W 12th Ave

Columbus, OH 432101267

Telephone 6146883763
Organization at the Same NPPES Address or Phone
Dental Clinics College Of Dentistry Facility NPI 1871608380

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Casey Kim has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Casey Kim as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Columbus and Ohio

302 active clinicians are listed under Dentist with a practice address in Columbus, OH (2,791 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Columbus

0% of these 302 clinicians have the CMS telehealth indicator.

0.3% of these 302 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-06-09
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES OH 30.027812

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

License # reported to NPPES OH RES.004612

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DENTIST

Medicare Enrollment ID

I20231202000208

Enrollment State Jurisdiction

OH

PECOS Control ID

1658729595

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

15 listed
Dr. Ben Blumberg , DDS

Dentist - General Practice

NPI 1982258372

Doctor of Dental Surgery

Deborah Bodunde

Dentist - Periodontics

NPI 1619604469
NPI 1902543630

Doctor of Dental Surgery

NPI 1730705666

Doctor of Dental Medicine

Dr. Guo-Liang Cheng , DDS, MS

Dentist - Periodontics

NPI 1861800872

Doctor of Dental Surgery, Master of Science

Gage Eberly

Student in an Organized Health Care Education/Training Program

NPI 1609496371

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2023

Student in an Organized Health Care Education/Training Program (license number reported to NPPES: OH RES.004612)

βœ…
NPI Profile Active April 18, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 18, 2023

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267 (Tel: 6146883763)

πŸ“
Business Mailing Address (Initial Record) April 18, 2023

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267

πŸ‘€
Provider Name / Credentials (Initial Record) April 18, 2023

Recorded as CASEY KIM

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 18, 2023

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 18, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962199364
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 18, 2023
Last Update: June 11, 2025
Sole Proprietor: Yes

Other Dentists in Columbus

All Dentists in Columbus

Mailing Address

305 W 12th Ave

Columbus, OH 432101267

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.