Kevin Song, DDS, PS

Primary specialty

DentistTaxonomy code 122300000X

License

60065174 Issued in WA

Legal business name

KEVIN SONG, DDS, PS

Practice address

5221 Pacific Ave
Tacoma, WA 98408-7625

Phone

(253) 475-1521

NPI assigned

Feb 5, 2013

Last updated

Feb 5, 2013By 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. Kevin Song, DDS

Title

President

Phone

(253) 475-1521

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Duane Hideo Mayeda, D.D.S.

  • General Practice Dentistry
  • Tacoma, WA
  • NPI 1821139486
  NPD (past)

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1164761540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087625",
            "telephone_number": "253-475-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN SONG, DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-475-1521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60065174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cobelli Kett, MD
• Benjamin James Kevan, DPT
• Kevin K. Gandhi, M.D., PLLC
• Kevin P. Schoenfelder, MD PS (Daniel P. Coffey, PA-C)
• Kevin P. Schoenfelder, MD PS
• Kevin Xu D.D.S., M.S.,P.S., Inc.
• Key Speech and Language LLC
• Lauren Keyser, ARNP
• Mollie Khachadoorian, RN
• Olga V Khait-Palant, MD

• Dentist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.