Active NPI
Song C Yi, D.D.S
- Dentist
- Yakima, WA
National Provider Identifier
1144439282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00009414
- Practice address
- 4039 W. Nob Hill Rd. Blvd.
Yakima, WA 98908 - Phone
- (509) 823-4480
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00009414 | WA | Primary |
Addresses
Primary practice location
4039 W. Nob Hill Rd. Blvd.
Yakima, WA 98908
Mailing address
4039 W. Nob Hill Rd. Blvd.
Yakima, WA 98908
Phone (509) 823-4480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00009414 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442534400000",
"number": "1144439282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4039 W. NOB HILL RD. BLVD.",
"city": "YAKIMA",
"state": "WA",
"postal_code": "98908",
"telephone_number": "509-823-4480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4039 W. NOB HILL RD. BLVD.",
"city": "YAKIMA",
"state": "WA",
"postal_code": "98908",
"telephone_number": "509-823-4480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YI",
"first_name": "SONG",
"middle_name": "C",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2015-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00009414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.