Individual provider Active NPI

Liansheng Song, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Farmington, CT
National Provider Identifier
1164599569
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
010234 Issued in CT
Practice address
263 Farmington Ave
Division of Oms L-7073, Mc1720
Farmington, CT 06030-1720
Phone
(860) 679-2583
Fax
(860) 679-1702
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 010234 CT Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 010234 CT

Addresses

Primary practice location

263 Farmington Ave
Division of Oms L-7073, Mc1720
Farmington, CT 06030-1720

Mailing address

263 Farmington Ave
Division of Oms L-7073, Mc1720
Farmington, CT 06030-1720
Phone (860) 679-2583

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10234CTMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: lsong10188@direct.med.uchc.edu

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1164599569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "DIVISION OF OMS L-7073, MC1720",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301720",
            "telephone_number": "860-679-2583",
            "fax_number": "860-679-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "DIVISION OF OMS L-7073, MC1720",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301720",
            "telephone_number": "860-679-2583",
            "fax_number": "860-679-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "LIANSHENG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CT",
            "license": "010234",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "010234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.