In Hee Song, D.M.D., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

OMS125 Issued in CA

Practice address

1004 Fowler Way Ste 9
Placerville, CA 95667-5746

Phone

(530) 328-0360

Fax

(530) 328-0365

NPI assigned

Feb 18, 2012

Sex

Male

Sole proprietor

Yes

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

Opted out of Medicare

Yes, effective Sep 3, 2021 through Sep 3, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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.

• In Hee Song DMD, MD, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Placerville, CA
  • NPI 1144092479
  NPD Authorized official
• Hudson Valley Oral Surgery, PLLC

  dba Hudson Valley Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Yorktown Heights, NY
  • NPI 1629443379
  NPD (past)

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

{
    "created_epoch": "1329523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1447523667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 FOWLER WAY STE 9",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675746",
            "telephone_number": "530-328-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 FOWLER WAY STE 9",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675746",
            "telephone_number": "530-328-0360",
            "fax_number": "530-328-0365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_2": "Box 1187",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296500",
            "country_code": "US",
            "telephone_number": "212-241-7681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "IN HEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,  M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-18",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "059801",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "294967",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Jordan Sobocinski, RADT-1
• Sohi Dentistry Professional Corporation
• Donna Soldano, MFT, ATR-BC
• Jessica Solomon, M.A.
• Julia Somera
• Sherri E Sonnenburg, OT
• Kristin Elizabeth Sornborger, RN, FNP
• Courtney Soto
• Michelle Lynn Spafford, MS, CCC-SLP
• Lynnette Diane Spencer, LYNNETTE SPENCER MFT

• Oral and Maxillofacial Surgery (Dentist) in Placerville, CA
• Providers in Placerville, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.