Sangchin Song, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02074400 Issued in NJ

Practice address

1828 W Lake Ave
Suite 201
Neptune, NJ 07753-4663

Phone

(732) 869-5770

Fax

(732) 869-5785

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Sangchin Song Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1154492676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 W LAKE AVE",
            "address_2": "SUITE 201",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534663",
            "telephone_number": "732-869-5770",
            "fax_number": "732-869-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 W LAKE AVE",
            "address_2": "SUITE 201",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534663",
            "telephone_number": "732-869-5770",
            "fax_number": "732-869-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "SANGCHIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02074400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANGCHIN",
            "last_name": "SONG",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara M Sochaczewsky, APN
• Nina Shah Solanki, MD
• Robin Solbach, PSYD
• Reka Somodi Manfre, APN
• Julee Song, MD
• Azam Soroush, MD
• Stephanie Soussan, APN
• Brianna Collins Spahn, PA-C
• Spark Home Care LLC
• Colton Dallas Spencer

• General Practice Dentistry in Neptune, NJ
• Providers in Neptune, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.