Discount Dental

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

048211 Issued in NY

Legal business name

DISCOUNT DENTAL

Practice address

14210 Roosevelt Ave # 8
Flushing, NY 11354-6046

Phone

(718) 460-6868

Fax

(718) 460-2112

NPI assigned

Mar 25, 2016

Last updated

Mar 25, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jun Song, DDS,MMSC

Title

Dentist

Phone

(718) 460-6868

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1033571203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 ROOSEVELT AVE # 8",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546046",
            "telephone_number": "718-460-6868",
            "fax_number": "718-460-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14210 ROOSEVELT AVE # 8",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546046",
            "telephone_number": "718-460-6868",
            "fax_number": "718-460-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOUNT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JUN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-460-6868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MMSC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057991",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057616",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "048211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02455109",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• DME Pro Inc
• Richard DO, PA-C

• Periodontics in Flushing, NY
• Providers in Flushing, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.