Dongkyu Song, L.AC DAOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

CQ-0000023 Issued in DE

Practice address

249 Philadelphia Pike
Wilmington, DE 19809-3109

Phone

(302) 482-3025

Fax

(302) 476-8176

NPI assigned

Feb 22, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Zen Wellness Center LLC

  • Acupuncturist
  • Wilmington, DE
  • NPI 1497260129
  NPD Authorized official

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1114196276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198093109",
            "telephone_number": "302-482-3025",
            "fax_number": "302-476-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198093109",
            "telephone_number": "302-482-3025",
            "fax_number": "302-476-8176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Haines St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197114610",
            "country_code": "US",
            "telephone_number": "302-525-4343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "DONGKYU",
        "credential": "L.AC DAOM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC9686",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "OM000100",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "DE",
            "license": "CQ-0000023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Solomon
• Angela Soltys
• Katherine Anne Somer, LPC
• William Sommers, D.O.
• Jeanette Youngjin Son, D.M.D.
• Monica Sunyoung Song, M.A. CCC-A
• Brandon Sonson
• Sony Healthcare Service
• Erica D. Sood, PHD
• Rafi Soofi-Siavash, M.D.

• All providers in Wilmington, DE
• Acupuncturist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.